complaint·February 28, 2025

Investigation consisted of the following: On 2/27/2025, a tour of the facility was conducted which included the dining room and kitchen area; 6 staff and 1 witness were interviewed; records were gathered. On 2/28/2025, a tour of the dining room was conducted during breakfast time and lunch time; a tour of the kitchen was conducted; pictures were observed of meals (pictures were dated and timestamped); 1 staff and 10 residents were interviewed; records were reviewed which consisted of staff roster, resident roster with their diet description, 5 residents physician’s reports (of residents who have special diets according to their physician), Healthcare Menus Direct for Recipe: Beef Goulash, staff records, Weekly Menus from December 2024 to June 2025, Cooks Spreadsheet for Spring Cycle Menus from March 2025 to May 2025, Dietary Quality Control Survey for January 2025 to February 2025, and Select Menu. Investigation revealed the following: Allegation: “Facility does not provide diets as prescribed by the resident(s) doctor”, it is being alleged that the facility does not provide residents with meals as prescribed by the residents’ doctor. Interviews conducted revealed the following: 10 out 10 residents denied the allegation, 7 out of 7 staff denied the allegation and 1 out of 1 witness denied the allegation. Observations revealed the following: The kitchen has diet slips and resident roster with their diet description posted on the wall. Each dining room table has diet cards for each resident. Diet cards consist of resident’s name, room number and diet (an example of a diet can be mechanical soft, thick liquids, no fish, allergic to peanuts, regular diet, etc.). On 2/28/2025, during breakfast and lunch time the department observed food being served to residents according to their dietary needs. On 2/28/2025 during breakfast and lunch time the department observed staff assisting residents with feeding for residents that require assistance. On 2/28/2025, before lunch time the department observed kitchen staff follow the Healthcare Menus Direct to create special diets (e.g. purees). Records reviewed revealed the following: In the kitchens office there is a Diet Slip binder (which consist of each residents diet) and a Healthcare Menus Direct binder for example the Recipe: Beef Goulash has a section for Special Diets such as low fat, low cholesterol, mechanical soft, dysphagia, pureeds, renal, gluten free and describes how to cook each special diet. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Facility does not provide menus that match foods that are served to residents”, it is being alleged that what is on the menu is not the same as the meals that residents are served. Interviews conducted revealed the following: 7 out 10 residents denied the allegation, 3 out 10 residents do not read the menus, 7 out of 7 staff denied the allegation and 1 out of 1 witness denied the allegation. Observations revealed the following: On 2/28/2025, the department observed that the facility followed the menu for breakfast and for lunch time. The Administrator has a large collection of pictures taken for lunch and dinner meals consisting of the regular meal and special diets such as mechanical soft and pureeds (each picture is dated and timestamped). The department observed that each meal corresponds with the Weekly Menu for February 24, 2025. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Allegation: “Facility does not provide good quality food”, it is being alleged that the food the facility provides to residents in care is not edible (e.g. food scraps thrown together). Interviews conducted revealed the following: 10 out 10 residents denied the allegation, 7 out of 7 staff denied the allegation and 1 out of 1 witness denied the allegation. Observations revealed the following: On 2/27/2025, the department toured the kitchen area which consisted of the dry good storage, freezers, fridges, etc. The department observed good quality food for example meats, vegetables, dairy products, and bread. On 2/28/2025, the department observed good quality breakfast and lunch meals being served to residents in care. Records reviewed revealed the following: Dietary Quality Control Survey for January 2025 to February 2025 indicates that the facility has good quality foods. The Administrator has a large collection of pictures taken for lunch and dinner meals consisting of the regular meal and special diets such as mechanical soft and pureeds (each picture is dated and timestamped). The department observed that meals looked of good quality. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. No deficiencies were cited. An exit interview was conducted, and a copy of this report was left with the Administrator, Heather Argueta.