Office review·July 27, 2021

An Informal meeting was held via tele conference. The purpose of the meeting is to address staffing shortages and operational changes. Attendees present during the meeting were: Community Care Licensing, Assistant Program Administrator Claire Matsushita, Licensing Program Manager (LPM) Lisa Hicks, Licensing Program Analyst (LPA) Noemi Galarza, and Royal Vista San Gabriel LLC corporate staff, Board Representative Kevin Chen, Nurse Consultant Francis Largoza, and Nursing Home Administrator/Consultant Chia Demurjian. On July 22, 2021, Community Care Licensing (CCL) obtained information there was staff shortages at the facility that resulted in lack of adequate care and supervision of residents. Only one (1) caregiver worked the PM shift. The caregiver provided care for residents in the Memory Care Unit, resulting in the 2nd and 3rd floor Assisted Living residents being unattended and without supervision. The following was discussed: Staffing shortages and excess work hours of current staff. Recent staffing changes and corporate hiring plan to address staffing issues. Staffing update of Registered Dietician and new Administrator. Staff responsibilities and duties. Clarification of facility security guard role and responsibilities. Corporate team acknowledged understanding of the seriousness of staffing shortages and health and safety issues. Operational changes resulting in lack of facility leadership by an Administrator or designated substitute. Medication management errors and staff training. Lack of corporate oversight during COVID-19 pandemic and recent operational changes and issues during the past several months. Future unannounced compliance case management visits. C CL requested the following: 1. Submit revised staffing plan and update Personnel Report list 2. Submit updated License Administrative Organization form 3 Special Incident Reporting 4. Reassessment of all residents in order to determine facility care needs. Exit interview conducted with Francis Largoza, Kevin Chen, and Chia Demurjian. A copy of the report was emailed to Nurse Consultant Francis Largoza.