Complaint·September 18, 2024

Allegation: Residents pendents are disabled due to transition between new management company. It is being alleged that residents’ pendants and bedroom phones have not been working for 5 days due to change in management companies. On 04/25/24 LPA Wendy Gibbs conducted interviews with staff #1-10 (S1-S10) regarding the allegation above, 9 of 10 staff interviewed confirmed the allegation above and reported the phones and pendants were down for a couple of days. 1 of 10 staff interviewed reported being unaware of the residents’ phones and pendants being down. On 04/25/24 LPA Wendy Gibbs conducted interviews with residents #1-4 (R1-R4) regarding the allegation above, 2 of 4 residents interviewed confirmed pendants were down, 2 of 4 residents interviewed reported being unaware of the pendants being down as the pendants are not used regularly. On 09/18/24 LPA Villegas conducted interview with resident 5-10 (R5-R10) regarding the allegation above, 3 of 6 residents interviewed confirmed pendants were down, 3 of 6 residents interviewed denied the allegation above. On 09/18/24 LPA Villegas conducted interview with executive director (ED) regarding the allegation above, Per ED, ED has no knowledge of the allegation above as ED was employed after the change in management. On 09/18/24 LPA conducted tour of the facility and conducted a pendant test of 3 random pendants, pendant were observed to be operational with response time of 5-8 minutes. Based on LPAs observations, interviews, and record review(s) conducted, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division (6) and Chapter (8) are being cited on the attached LIC 9099D. Exit interview conducted with Executive Director Stephanie Koffman, appeal rights explained, and a copy of this report was provided. Allegation: Residents missed meals due to phones not working due to transition between new management company It is being alleged that residents were unable to order their meals due to the phones being down. On 04/25/24 LPA Wendy Gibbs conducted interviews with staff #1-10 (S1-S10) regarding the allegation above, 6 of 10 staff interviewed reported being unaware of the allegation above, 2 of 10 staff interviewed denied the allegation above and reported meals were provided to all residents in care, 2 of 10 staff interviewed confirmed the allegation and stated there were residents who reported not receiving a meal. On 04/25/24 LPA Wendy Gibbs conducted interviews with residents #1-4 (R1-R4) regarding the allegation above, 4 of 4 residents interviewed denied the allegation above and reported receiving 3 meals a day. On 09/18/24 LPA Villegas conducted interview with resident 5-10 (R5-R10) regarding the allegation above, 6 of 6 residents interviewed denied the allegation above and reported receiving 3 meals a day. On 09/18/24 LPA Villegas conducted interview with executive director (ED) regarding the allegation above, per ED since ED took over there have been no issues with the facility phones and there have been no reports of any residents missing any meals. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted with Executive Director Stephanie Koffman, and a copy of this report was provided.