Complaint·October 13, 2021

The investigation revealed the following: S1 confirm that there is a staff person that is not complying with the mask mandate nor are they willing to be tested weekly. S1 states, S6 is no longer able to work with clients but performs duties such as cleaning. S2 states that they always have to “correct” S6 about wearing a mask while in the facility. “The facility staff and families are scared they or their family member might catch covid due to the persons exposure while on public transportation.” S3 states not knowing the staff person. S4 confirmed the allegation to be true and states they have received several complaints from the families regarding S6. S5 states having to remind the staff to put on their mask. “S6 usually complies when I ask them to put on their mask.” S6 states that they only wear a mask around other people regardless of being in the facility. They state, “they do not trust being tested so they do not comply because it is a violation of their constitutional right.” During an interview with witnesses the following was discovered: RP states, S6 has expressed their opinion in being against vaccination, testing and wearing a mask as reason not to follow the mask mandate. W1 states they have expressed concern to the licensee over S6 lack of compliance. “It’s alarming that the facility hasn’t done anything.” W2 states, S6 will put on a mask only when “I or the families walk into the facility and will take it off once we leave.” W2 states they have walked in many times to see S6 without a mask. LPA attempted to conduct interviews with the residents, but they were not capable of responding to interview questions. The following Provider Information Notice (PIN) was provided to the Licensee that addresses unvaccinated staff, weekly testing, mask mandate and full vaccination mandate (Nov 2021): PIN 21-32.1-ASC, PIN 21-38-ASC and PIN 21-44-ASC Based on the investigators interviews conducted with licensee, caregivers, families of the residents, and evidence provided, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22 Division (6) and Chapter (8) are being cited on the attached LIC9099-D. An exit interview was conducted with caregiver and a hard copy was provided with appeal rights. See LIC 9009-D on the next page.