complaint·September 30, 2021

Nine out of the sixteen staff interviewed agreed the facility is short staff. It was reported that dietary is short staff when staff call off. Med Techs are short staff in the 3 pm - 11 pm shift and on the graveyard. Staff report that residents have received medications late and or treatments. Many Med Techs are asked to cover shifts when people call off. On the 3 pm - 11 pm shift many times there are two Med Techs passing medication for the first floor, second floor, garden area, and memory care unit. According to staff, that is not enough people to pass medication. Sixteen out of the twenty four residents interviewed agreed facility is short staff, particularly in the Med Tech department. Residents reported receiving their medications or treatments late or not at all. Residents reported seeing many of the staff working double shifts because according to residents, the facility is short staff. Based on the information obtained, the allegation is substantiated. Allegation: Facility is mismanaging the resident(s) medication(s). As mentioned above, staff confirmed residents are receiving medications and treatments late. Treatments include ointments, eye drops, and breathing treatments. Residents confirmed they have received medications and treatments late. One resident mentioned they had a hard time breathing and had to wait for hours until the Med Techs assisted with the prescribed inhaler. Based on the information obtained, the allegation is substantiated. Allegation: Staff are not administering medications to residents as prescribed. As mentioned earlier staff confirmed medications and treatments are being administered late. Residents confirmed they are receiving medications and treatments late or they don't get them at all. Based on the information obtained, the allegation is substantiated. Allegation: Resident's dietary needs are not being met. Sixteen out of the twenty four residents interviewed agreed their dietary needs are not being met because the food is bad. Residents reported the meats are dry and sometimes undercooked. They report too much pork is being served and there are not enough options if residents don't want what is on the menu. Yogurt used to be an option for residents in the morning, but that is no longer available. According to kitchen staff, yogurt is no longer in the budget. It was reported that the drinks are watered down and taste bad. Several residents reported they have lost a lot of weight because they don't eat the food in the facility. All the staff interviewed confirmed residents do complain about the food often. The facility did contract with a different meat vendor, however residents still complain about how the meats are cooked. Based on the information obtained, the allegation is substantiated. Continued on 9099C. Allegation: Food services are inadequate. As mentioned above, residents confirmed they are not happy with the food and many choose not to eat it. Also many residents indicated the food is cold when it's served. Due to COVID-19 many residents are choosing to eat and be served in their rooms instead of entering the dining room. Once the meals are served in the rooms the food is cold. Some staff interviewed confirmed the food is cold by the time the food is served to residents in their rooms. Based on the information obtained, the allegation is substantiated. Allegation: Facility is dirty. It's alleged the carpet in the hallway is stained. LPA toured the facility and noticed there were several stains on the second floor carpet in the hallway. According to staff, maintenance is responsible for deep cleaning the carpets. However, there has been a shortage of maintenance staff and therefore, the carpets have been neglected. At one point the facility only had two maintenance staff for a building of a capacity of 343. The facility has since hired one additional maintenance staff. Based on the information obtained, the allegation is substantiated. Based on LPAs observations and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D. Exit interview held. A copy of the report and appeal rights were provided. Allegation: Untrained staff administering medication. Allegedly there is an employee of the facility that is a driver and is also assisting residents with medication. Staff training was reviewed and it was confirmed the driver has the training on file. The driver was interviewed and also confirmed the medication training. Med Techs interviewed stated all staff assisting with medications have been trained properly. None of the residents interviewed indicated having any medication issues that included the driver in question. Based on the information obtained, the allegation is unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Exit interview held. A copy of the report was provided.