complaint·May 6, 2021

The complaint report was forwarded to the Investigative Bureau via fax. A full investigation was conducted by IB Investigator, Peter Zertuche, for the case. The IB Investigator interviewed the Complainant on January 25, 2021. Complainant stated noticed numerous marks and bruises on resident’s chest and shoulder. The complainant reported resident was intubated and resident was unable to answer questions. Resident’s health declined and complainant stated the resident passed away on December 31, 2020. Complainant stated the injuries appeared suspicious but was unsure as to the resident’s past history and the cause of death was unknown but appeared to be unrelated. Tannya Quezada, Administrator Designee for the facility was interviewed by IB Investigator on January 26, 2021. Administrator Designee stated facility staff were aware of the bruising and noticed bruising when resident returned from a Kaiser Hospital visit prior to resident’s hospitalization at the Antelope Valley Hospital. Administrator Designee contacted Kaiser regarding the bruises, but Kaiser staff stated they were unable to locate documentation regarding the doctor’s visit. Administrator Designee stated resident was diagnosed with cancer and severe anemia. She also stated the resident was taking blood thinner medications. Administrator Designee stated the resident had not been hit by any staff member and there was no report of a fall. IB Investigator interviewed a caregiver who stated they noticed resident’s bruising and reported the bruising to the Medication Technician at the facility. The Medication Technician then confirmed with the caregiver the resident sustained the bruising due to a blood transfusion at the hospital. Ted Bonzon, the Licensee for the facility was interviewed on Mach 8, 2021. Licensee stated resident refused to take medications on numerous occasions. IB Investigator interviewed one of the resident’s treating physician from the hospital on March 9, 2021. The doctor stated the resident arrived on December 24, 2020 and recalled treating the resident and noticed the bruising. The doctor and peers reviewed the case and concluded that the cause of the bruising could have occurred due to the IV. The doctor also stated the resident was diagnosed with leukemia and was on blood thinners which caused the resident to bruise very easily. In conclusion, the facility reported no unusual incidents and stated that the bruises may have been caused due to the victim’s illness and IV attempts. Medical records indicate the cause of the injuries may have been due to IV and low platelets which was confirmed by the admitting doctor who reported the victim had an IV placed in the areas of bruising and was diagnosed with leukemia, was on blood thinners and bruised easily. The IB Investigator concluded the findings are unsubstantiated. An exit interview was conducted, and a copy of the report sent to Administrator Designee requesting the Administrator Designee’s signature. LPA Spaeth requested signed copy of the report be sent to LPA via email by Monday, May 10, 2021.