complaint·August 10, 2023

Regarding Allegation #1 : Facility is infested with cockroaches. This complaint alleged facility has a pest control problem. LPA Calderon conducted an interview with A1. A1 relays pest control comes one time per month and sprays for pests in the common areas. A1 relays that staff also will address any reports of roaches and will spray for roaches. LPA Calderon conducted an interview with S1-S4. 4 out of 4 staff relays that there are water roaches that come from the water pipes. 4 out of 4 staff state that they have seen roaches in the hallway, and they also spray roaches. LPA Calderon conducted an interview with R1-R8. R1 and R8 relay that there are no roach problems. R2-R7 relays that they have seen roaches in the hallway, water pipes and inside their bathrooms. R2-R8 relay that pest control does spray for insects and staff also sprays for roaches. On 08/10/2023 LPA Calderon toured common areas of facility; LPA Calderon did not see any roaches. Regarding Allegation #2 : Resident dietary needs are not being met. This complaint alleged residents’ dietary needs are not being met. LPA Calderon conducted an interview with A1. A1 relays that the facility does not provide a separate meal plan for diabetic residents. LPA Calderon conducted an interview with R1-R8. R1 states that R1 us diabetic and the facility does not offer a diabetic meal plan. R2-R8 relay that they are diabetic, and the facility does not offer residents a meal plan for diabetic residents. LPA Calderon reviewed the meal plan for the facility, there is no meal plan found for diabetic residents. Based on LPA Calderon observations and interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the above allegations “facility is infested with cockroaches” “residents dietary needs are not being met” is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 are cited on the attached LIC 9099D. An exit interview was conducted, and a copy of the Complaint Report and Appeal Rights were provided to the Assistant Administrator Tonantzin Martinez (A1). Regarding Allegation #1 : Staff are injecting insulin for residents. This complaint alleged staff are injecting residents with insulin. LPA Calderon conducted an interview with A1. A1 relays that only a LVN is allowed to give insulin injections to residents in care. A1 relays that at no time do staff ever inject residents with insulin as they are not trained. LPA Calderon conducted an interview with S3. S3 relays that at no time does any facility staff other than a trained LVN inject insulin residents in care and that the home health care nurse comes 2 times per day and this person takes care of resident’s insulin needs. LPA Calderon conducted an interview with R1-R8. 7 out of 8 residents relay that they are diabetic and that the nurse with home health care services come to the facility 2 times per day and gives them their insulin injections. 7 out of 8 residents relay that no facility staff has ever given them the insulin injection. R8 relays that R8 is not a diabetic. Reviewed House Call MD (date 4/2/2021, 7/22/2022) House Call MD serviced R8 for catheter, compaction stool and UTI Regarding Allegation #2 : Non-skilled staff are performing manual fecal impaction removal on resident. This complaint alleged non-skilled staff are performing fecal removal on resident in care. LPA Calderon conducted an interview with A1. A1 states that Steward Home Health Care LVN staff comes to the facility and performs fecal removal on R8. A1 states that no facility staff have the training to perform the fecal removal on residents in care. A1 relays that no facility staff would be allowed to perform the fecal removal on any resident in care. LPA Calderon conducted an interview with S3. S3 relays that the home health care LVN performs the fecal removal on R8, and no facility staff would be allowed to perform the fecal removal on any resident in care. LPA Calderon conducted an interview with R1-R8. 7 out of 8 residents do not have fecal removal done by staff or home health care nurses. LPA Calderon conducted an interview with R8. R8 relays that Steward Home Health Care LVN performs the fecal removal, and no staff has ever performed the fecal removal on R8. R8 relays that R8 is not a diabetic. Reviewed House Call MD (date 4/2/2021, 7/22/2022, 1/31/2023) House Call MD serviced R8 for catheter, compaction stool and UTI. Regarding Allegation #3 : Residents are prohibited from using a home health agency of their choosing. This complaint alleged facility did not allow residents to choose their own health care plan. LPA Calderon conducted an interview with A1. A1 relays that residents are given 5 options for home health care services and one option is Steward Home Health Care. A1 relays that resident is not prohibited from using another home health care company. LPA Calderon conducted an interview with R1-R8. 7 out of 8 residents did not know the name of the home health care company LVN worked for. R8 relays that R8 understood the name of the home health care company LVN worked for. On 08/10/2023 LPA Calderon reviewed the home health care provider's information. 30 total residents have Home Health Care (HHC) services of which 16 have Steward and other have HHC services options. R8 relays that R8 is not a diabetic. Reviewed HouseCall MD (date 4/2/2021, 7/22/2022, 1/31/2023) HouseCall MD serviced R8 for catheter, decompaction stool and UTI. Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has NOT been met; therefore, the allegations of “staff are injecting insulin for residents” “non-skilled staff are performing manual fecal impaction removal on resident” “resident are prohibited from using a home health agency of their choosing” is found to be UNSUBSTANTIATED. An exit interview was conducted, and a copy of the Complaint Report was provided to the Assistant Administrator Tonantzin Martinez (A1).