complaint·September 10, 2024

To investigate this complaint, LPA requested copies of facility documents relevant to the investigation at 12pm, records included but not limited to residents’ and staff roster, and R1’s facility file, including but not limited to R1’s identification information, Physician report, advanced directives, DNR, and other records. LPA de la Cerra reviewed the file between 12:30pm and 1:00pm. Staff interviews were initiated between 12:00pm and 12:30pm. A Review of R1’s resident file revealed that R1 has a signed advance directive, DNR – Do Not Resuscitate, a form previously requested by the emergency personnel. Staff interviews confirmed that S1 did not have R1’s file readily available for emergency personnel. Based on inspection, observation, interviews and record reviews, there is sufficient information to support the allegation. Therefore, the allegation is substantiated at this time. Per CA Code of Regulations, Title 22 Division 6, Chapter 8, the following deficiency was cited and recorded on LIC9099-D. During this investigation, LPA noted other Title 22 Deficiencies. Therefore, Case Management visit was conducted in conjunction with complaint investigation to address other deficiencies unrelated to the complaint. Exit interview was conducted, appeal rights discussed, and a copy of report was issued to facility