complaint·April 15, 2021

On 3/25/2021, LPA Lourdes Montoya reviewed the following records: Facility’s Resident roster, Staff roster, Resident #1’s Admission Agreement, Physician’s Report, Appraisal/Needs and Services Plans, and Record of Resident’s Safeguarded Cash Resources. Investigation Revealed the Following: Based on record review, Admission Agreement shows Resident #1, the victim, was admitted to the facility on 3/13/2019. Maintenance or supervision of resident cash resources was not added to basic services the facility provides. The Record of Resident’s Safeguard Cash Resources form indicates the facility does not handle resident’s cash resources. According to the Physician’s Report dated 3/4/2021, Resident #1 has mild cognitive impairment but she is able to follow instructions, communicate her needs, and leave the facility unassisted. The Appraisal/Needs and Services Plan indicates Resident #1 is alert, ambulatory with mild cognitive impairment. The plan also states Resident #1 needs daily monitoring and observation. On 3/21/2021, LPA Montoya contacted the listed facility number (310) 989-1941 and spoke with Staff #8 who denied that she is the administrator or the licensee of the facility. Per LPA's review of LIC 309 dated 1/9/2019, Staff #8 is the Chief Executive Officer of Senior Manor Care, Inc. The department has not received a request from the Licensee to change the chief corporate officer of the organization or corporation to date. During the virtual tour for health and safety checks on 3/21/2021, LPA Montoya observed residents are well, the home is clean and in order, there are sufficient perishable and non-perishable food supplies, PPE and hygiene supplies were readily available to staff, both on-duty staff are wearing a face covering, and the facility has two caregivers providing care to four residents. LPA observed two side gates are not secured with padlocks, and the facility's surroundings are free of hazard. LPA checked all exit doors for monitoring of residents with memory care needs. LPA observed the main entrance and two sliding doors have working auditory devices; however, the sliding door in bedroom #2 has a non-working auditory device while the sliding door in bedroom #3 does not have an auditory device. Report continued in LIC 9099C Resident eloped from facility. It is alleged that resident eloped from the facility. The Department interviewed residents and staff. Resident #1 stated she does not remember eloping from the facility. Interviews with Residents #2 and #3 revealed they have not heard or observed that a resident eloped from the facility. Residents #4 and #5 did not respond to the interview questions because they had hearing difficulty. Interview with Staff #1 & #2 indicates they have not heard or observed any resident eloped from the facility. Staff #3 stated he was not working yet at this facility when Resident #1 resided in this facility. LPA attempted to interview Staff #4 but could not obtain a statement because he is out of the country, according to Staff #2. Staff #5 and #6 stated they started working at this facility in February 2020 when Resident #1 has already relocated to another facility. They said they could not answer the questions regarding this allegation because they did not meet Resident #1 in this facility. Staff #7 stated she heard that Resident #1 went out but with a caregiver's supervision. LPA attempted to interview Witness #1, who was Resident #1’s former Responsible Party. LPA was informed by Witness #1’s family member that he already passed away. Based on Department’s observations, record review, and interviews, the department did not find sufficient evidence to corroborate this allegation. Facility did not safeguard resident's cash. It is alleged that facility did not safeguard resident’s cash. The Department interviewed residents and staff. Residents #1, #2, and #3 denied the facility did not safeguard their cash. They stated the facility does not handle their cash resources. Residents #4 & #5 did not respond to LPA’s questions because they had hearing difficulty. Staff #1, #2 and #7 denied the facility did not safeguard residents’ cash. They stated the facility does not handle residents’ cash resources. LPA attempted to interview Staff #4 but could not obtain a statement because he is out of the country, according to Staff #2. Staff #5 and #6 stated they started working at this facility in February 2020 when Resident #1 has already relocated to another facility. They said they could not answer the questions regarding this allegation because they did not meet Resident #1 in this facility. LPA attempted to interview Witness #1, who was Resident #1’s former Responsible Party. LPA was informed by Witness #1’s family member that he already passed away. Based on Department’s observations, record review, and interviews, the department did not find sufficient evidence to corroborate this allegation. Based on information gathered, the Department did not find sufficient evidence to support the allegations, “Resident eloped from facility” and “Facility did not safeguard resident's cash”. Although the allegations may have happened or are valid, there is not enough preponderance of evidence to prove the alleged allegations are valid did or did not occur. Therefore, the allegations are "UNSUBSTANTIATED”. A telephonic exit interview was conducted with Licensee Angelique, and an electronic copy was provided via email for signature.