complaint·November 17, 2021

The investigation revealed the following: Based on record review, the Admission Agreement shows Resident #1, the alleged victim, was admitted to the facility on February 4, 2020. According to Appraisal/Needs and services plan dated 2/11/2020, Resident #1 refused to review and participate in the appraisal. Allegation: Staff failed to provide adequate food service It is alleged that Staff failed to provide adequate food service. The department attempted to interview Residents (#1-#11); Resident #1 was not available for interview because he was out of the facility; Residents (#2-#10) were available for interview; two (2) Residents (#11 and #12) refused to be interviewed. The department’s interview revealed out of nine (9) interviewed residents, eight (8) Residents (#2, #3, #4, $5, #6, #7, #8 and #10) are satisfied with the facility’s food service. Only one (1) Resident (#9) stated food service is not good. Staff #1 and #2 disclosed there is only one resident who keeps complaining about the facility’s food service, but this resident does not take or eat the food provided by the facility. Staff #3, the kitchen supervisor, explained sometimes residents make special requests and the kitchen staff always try to accommodate all residents and ensure the food services are beyond satisfactory. Staff #4-6 reported they have not heard complaints from resident about the facility’s food service. Per department’s review, it is noted in the facility’s Resident Dining Details Report that Resident #5, who stated in the interview the food service is bad, has food allergies and supplements/food preferences. This report was created and maintained to meet the residents’ special needs and requests, according to the Dietary Supervisor (Staff #3). The department also observed in the facility’s Summer Menus that the facility maintains a daily diet of quality and quantity necessary to meet the needs of the residents. Based on LPA’s observations, interviews, and records review, LPA did not find sufficient evidence to support the allegation mentioned above. Allegation: Insufficient staff to meet the needs of the residents It is alleged the facility has insufficient staff to meet the needs of the residents. The department attempted to interview Residents (#1-#11); Resident #1 was not available for interview because he was out of the facility; Nine Residents (#2-#10) were available for interview; two Residents (#11 and #12) refused to be interviewed. interview with nine residents (#2-#10) revealed the facility has sufficient staff to meet their needs. Staff #1-#6 stated there is sufficient staff in all shifts to meet the needs of the residents. Review of the Personnel Report indicated the facility has three work shifts and there is sufficient staff to meet the needs of the residents. Based on LPA’s observations, interviews, and records review, LPA did not find sufficient evidence to support the allegation mentioned above. Allegation: Staff are unable to communicate with residents due to a language barrier It is alleged staff are unable to communicate with residents due to a language barrier. The department attempted to interview Residents (#1-#11); Resident #1 was not available for interview because he was out of the facility; Nine Residents (#2-#10) were available for interview; two Residents (#11 and #12) refused to be interviewed. The department’s interview revealed Residents #2-#8 are able to communicate with residents without a language barrier. Residents #9 and #10 claimed caregivers are unable to communicate well with them because the caregivers only speak Spanish. Staff #1-#6 stated they communicate well with residents. The department’s interview with Staff #1-#6 revealed they communicate well, and no language barrier was observed. Based on LPA’s observations, interviews, and records review, LPA did not find sufficient evidence to support the allegation mentioned above. REPORT CONTINUED IN LIC 9099C Allegation: Staff mismanaged resident's medication. It is alleged staff mismanaged resident’s medication. The department attempted to interview Residents (#1-#11); Resident #1 was not available for interview because he was out of the facility; Nine Residents (#2-#10) were available for interview; two Residents (#11 and #12) refused to be interviewed. Residents (#2-#10) revealed in interviews that staff did not mismanage their medications. Staff (#1-#2) stated they did not receive a complaint regarding mismanagement of resident’s medication. Staff (#3) refused to make comments regarding this allegation. Staff (#4-#6) revealed in interview that no residents are having problems receiving their medications. Based on LPA’s observations, interviews, and records review, LPA did not find sufficient evidence to support the allegation mentioned above. Allegation: Staff not responding to residents call button It is alleged the Staff not responding to residents call button. The department attempted to interview Residents (#1-#11); Resident #1 was not available for interview because he was out of the facility; Nine Residents (#2-#10) were available for interview; two Residents (#11 and #12) refused to be interviewed. The department’s interview revealed Residents (#2, #3, #5, and #7) do not use the call button in their bedroom. They said they prefer to go to the front desk for assistance. Residents (#6 and #8) stated facility staff respond quickly when they use the call button for assistance. Resident (#4), whose bedroom is #6A, reported the call button in the bedroom is inoperable. Resident #9 reported he does not have a call button in his bedroom. Resident (#10) stated the call button in her bedroom (# 35B) does not work. Staff #1 mentioned the dashboard of residents’ call buttons is located in the office/front desk and staff respond quickly to residents’ calls. Staff (#1) also reported the call buttons in bedrooms #1, #35 and #38 are not operable. Staff #2 reported staff respond quickly to residents’ calls unless but there are call buttons that are not working. Staff #3 refused to make comments regarding this allegation. During the department’s tour of the facility on 7/21/2021, it was observed that some bedrooms have broken call buttons but residents whose call buttons are operable stated staff respond quickly to their calls. Based on LPA’s record review, the facility has an ongoing repair plan of the broken call buttons. Based on LPA’s observations, interviews, and records review, LPA did not find sufficient evidence to support the allegation mentioned Allegation: Facility is unclean It is alleged that the facility is unclean The department attempted to interview Residents (#1-#11); Resident #1 was not available for interview because he was out of the facility; Nine Residents (#2-#10) were available for interview; two Residents (#11 and #12) refused to be interviewed. All nine interviewed resident (#2-#10) revealed the facility is clean. Staff #1 and #2 stated they did not receive a complaint regarding this allegation. Staff #3 refused to make comments regarding this allegation. Staff (#4-#6) stated the facility is clean every day. Based on LPA’s observations, interviews, and records review, LPA did not find sufficient evidence to support the allegation mentioned Based on information gathered, LPA did not find sufficient evidence to support the allegations, “ Staff failed to provide adequate food service”, “Insufficient staff to meet the needs of the residents”, “Staff are unable to communicate with residents due to a language barrier”, “Staff mismanaged resident's medication”, “Staff not responding to residents call button”, REPORT CONTINUED IN LIC 9099C and “Facilityis unclean”. Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are Unsubstantiated. No deficiencies were cited. An exit interview was conducted. A hard copy of the report was provided to Elizabeth Hernandez.