complaint·March 18, 2026

Allegation: Staff are not assisting resident with medications Investigation Finding: Substantiated During investigation, LPAs P Manalo and D Panlilio conducted interviews with reporting party (RP), resident (R1) and facility staff (ED, S1, S2) and reviewed resident (R1) documents. On 03/03/26, LPA P Manalo interviewed RP who stated that staff were not assisting R1 with his Lovenox injections. RP stated that the injection requires two working hands, one to pinch subcutaneous fat and the other to inject the medication. RP stated R1 can only use one hand due to a weakness in his left hand. RP stated that he spoke with S1 who assured him that staff would assist R1 with the injection. However, when RP spoke with R1 again, R1 told him that he had to inject the medication himself and that staff just handed him the injection. S2 confirmed with LPA that staff only handed R1 the injection and let him administer the injection himself. Based on LPA’s observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) that staff are not assisting resident with medications was found to be substantiated. Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided. Allegation: Staff are not ensuring resident’s medical needs are met Investigation Finding: Unsubstantiated During investigation, LPAs P Manalo and D Panlilio conducted interviews with reporting party (RP), resident (R1) and facility staff (ED, S1, S2) and reviewed resident (R1) documents. RP stated R1 did not have a hospital bed upon admission at the facility on 02/06/26. On 03/03/26, LPA P Manalo confirmed with staff (Marketing, S2) that R1 did not have a doctor’s order for a hospital bed with rails on admission because they were waiting for Medi-Cal to complete R1’s paperwork for the transfer. RP told LPA that the facility provided R1 with the hospital bed with rails on 02/07/26. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff are not ensuring resident’s medical needs are met is unsubstantiated. Allegation: Due to lack of supervision, resident was hit by another resident Investigation Finding: Unsubstantiated During investigation, LPAs P Manalo and D Panlilio conducted interviews with reporting party (RP), resident (R1) and facility staff (ED, S1, S2) and reviewed resident (R1) documents . Review of incident reports dated 02/25/26 and 03/01/26 showed R1 had an argument with another resident (R2) while eating breakfast in the dining room. R2 punched him in his right eye when R1 tried to stop R2 from grabbing his wheelchair. Both incidents showed staff redirected R1 and R2, called 911 for R1 to be evaluated and treated at the hospital. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation that staff failed to supervise resident is unsubstantiated. Exit interview conducted and a copy of this report provided.