Complaint·July 17, 2025

interviews conducted and information gathered it was revealed by ALW Representative that Resident R1's blood pressure is currently not checked. Stated due to age staff should check for safety on Resident R1 during rounds at nite, but they have not been. Resident R1 stated she does want to be checked by staff at night, but they have not been. Stated she is independent at alot of things but still needs help with blood pressure. Also said she has fallen in past and has had dizziness. Staff stated that R1 is independent with no services and does not need staff to assist her. Based on interviews conducted and document review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiency is being cited according to California Code of Regulations, Title 22. See LIC9099D. In regards to the allegation Staff did not conduct a reassessment of a resident while in care, based on interviews conducted and information gathered ALW Representative stated that Resident R1 has a care plan and was assessed by their nurse. Said facility was suppose to reassess and they didn't. Ombudsman stated that Resident R1 had a care plan and was assessed and met requirements for ALW program. It was revealed by ALW Representative that Resident R1's blood pressure is currently not checked. Stated due to age staff should check for safety on Resident R1 during rounds at nite, but they have not been. Staff stated that there was no change in condition so there was no need for reassessment. Based on interviews conducted and document review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiency is being cited according to California Code of Regulations, Title 22. See LIC9099D. In regards to the allegation Staff are unlawfully evicting a resident, based on interviews conducted and information gathered ALW Representative stated that there is an Official Form from the state that Resident R1 is enrolled in ALW dated 01/16/24. Interview with Department of Health Care Services (DHCS) Representative who stated Resident R1 is on the ALW Program and if conditions change (R1's husband passing away) and the resident has a contractual obligation signed at admission and the resident can not pay the rate to stay in the private room the facility can offer another room which allows the beneficiary to live in an RCFE approved room. Staff interviewed stated that Resident R1 is not being evicted at all. Said it is a transfer still in a private room and it has a shared bathroom. On 05/17/19 Resident R1 moved into Kingsley Manor and the Addendum To Resident Agreement Document was signed. On that document it states that if they become eligible for financial assistance they will be required to move to the first available private studio apartment with a shared bathroom as a condition of receiving assistance and continued residency at Kingsley Manor. On 1/10/24 the Amenity Form was submitted with no box checked to waive room. However, this does not supersede the Addendum fro 5/17/2019 signed at time of admission. Resident R1 stated she has stress and anxiety from possible move and said she spoke with ALW and Ombudsman who stated that she is enrolled in ALW. 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.