complaint·March 10, 2022

posted in a prominent place, sufficient 60-day supply of required personal protective equipment; reviewed R1's physician's report, medication administration record, cash resources (from 01/01/20 - 01/21/22), trust transaction history (from 01/01/19 - 03/10/22); incident reports (dated 11/20/20, 09/08/21, 10/13/21, 10/20/21, 11/18/21,12/08/21, 12/26/21, 01/20/22); behavioral contracts (dated 11/25/19 & 02/16/21); correspondence (dated 10/20/21 & 11/19/21) e-mailed to assisted-living waiver program social worker/supervisor, 30-Day Eviction Notice (dated 02/02/22), Summons Unlawful Detainer-Eviction (dated 03/10/22). Allegation: Facility is not following COVID-19 guidelines : The complaint alleges that Resident #1 had requested to be tested in its room on 11/23/21; and, it was done. On 12/01/21, Resident #1 requested to be tested (again) in its room; however, Administrator Fuentes advised that only the residents who cannot walk to the Activity Room (located on the first floor) will be tested in his/her room. At that time, Resident #1 was advised that if a resident is able to walk then the resident shall come to the Activity Room (located on the 1st floor) for his/her testing; otherwise, a resident can choose to go elsewhere to be tested at will. On 12/08/21, Resident #1 walked to the Activity Room (located on the 1st Floor) for its COVID testing. LPA/RA Ceniceros spoke with residents (R1-R7) in regards to testing in the Activity Room (located on the 1st Floor) rather than it their room; and, the majority residents stated that he/she has not had an issue with receiving his/her test by walking to the facility's Activity Room. LPA/RA Ceniceros spoke with facility staff (S1-S9); and, it was explained that the residents did not mind receiving his/her test in the facility's 1st floor Activity Room. Administrator Fuentes stated that when it first struck on or about October 2021, the residents were receiving tests in his/her room; however, since it was lifted on or about January 2022, residents returned to the facility's Activity Room (located on the 1st floor) to receive his/her test. Unless a resident couldn't walk, the contracted nurse would test the resident in his/her room. During LPA Cifuentes initial 10-Day visit on 12/21/21, it was observed that residents and facility staff were wearing his/her face mask and practicing social distancing. In addition, LPA/RA Ceniceros observed the residents and facility staff wearing his/her face mask during this visit. Allegation: Resident is being illegally evicted: The complaint alleges that while Resident #1 was receiving a test on 12/08/22 by the contracted nurse that (Report continued on LIC 9099C) Resident #1 was told that the facility was looking to evict the resident; as a result that the resident wanted to be tested in its room on 12/01/21; since it was done by the contracted nurse on 11/23/21. Administrator Fuentes stated that R1 has had behavioral issues with facility staff and residents that the facility began documenting incidents and reporting to LPA Stephanie Cifuentes; and, Licensing approved the 30-Day Eviction Notice. [RA Ceniceros reviewed the " Behavioral Contract " (dated 11/25/19) that listed issues that involved R1 of incidents (dated 06/16/19, 06/29/19, 07/15/19, 08/23/19, 09/05/19, 10/23/19, 10/28/19, 11/15/19, 11/19/19); and, serious incidents (dated 11/10/20,) regarding R1's aggressive act to another resident & staff. An incident had occurred (dated 11/10/20) involving R1 displaying aggressive behavior towards another resident & staff. R1 gave the facility a letter that he "quit" that he was not going to help with daily calendar or feed the fish anymore. An updated " Behavioral Contract " (dated 02/16/21) was created for R1 due to recent problems and inappropriate behavior. Administrator Fuentes indicated that Assisted-Living Waiver Social Worker (Shimika Blackwell) was notified (via e-mail, dated 10/20/21) and Assisted-Living Waiver Supervisor (Aida Sixtos) was notified (via e-mail, dated 11/19/21); and, the Long-term Care Ombudsman. Administrator Fuentes stated that R1 has continued to verbally harass facility staff and intimidating the residents. Instructions have been directed to facility staff to call 9-1-1 (Gardena Police Department) if need be due to R1's aggressive behavior. LPA/RA Ceniceros spoke with residents (R1-R7) in regards to having knowledge of a resident being evicted from the facility; and, the majority were unaware. LPA/RA Ceniceros spoke with facility staff (S1-S9) regarding a resident being evicted; and, the majority were unaware. Allegation: Facility is retaliating against resident for making complaints: The complaint alleges that Resident #1 is being treated differently by not being welcomed anymore and was followed by an eviction notice - believed to all be retaliatory in nature. LPA/RA Ceniceros spoke with residents (R1-R7) in regards to facility retaliating against him/her or another resident; and, the majority of these residents indicated that the facility has not used retaliating tactics against him/her or observed at another resident. LPA/RA Ceniceros spoke with facility staff (S1-S9) regarding facility retaliating against a resident; of which, he/she has not observed retaliation towards a resident. Based on information gathered through interviews, observations, and records review, the Department did not find sufficient evidence to support the allegations mentioned above. 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 . An exit interview was conducted and a copy of this report was provided to Administrator Susana Fuentes.