complaint·August 2, 2023

• Physician’s Reports dated: 7/13/20 and 3/22/22 • Preplacement Appraisal Information • Identification and Emergency Information • Consent for Emergency Medical Treatment • Release of Client/Resident Medical Information • Admission Agreement • Resident Roster • Personnel Report The investigation revealed the following; Allegation: Resident missed scheduled optometrist appointments while in care. Based on interviews conducted, there were multiple statements obtained which were consistent and corroborated with the above-mentioned allegation. R1 had an appointment scheduled with an Optometrist sometime in October or November of 2021 (exact date unknown) and R1 ended up missing her appointment due to facility not providing transportation and failing to make arrangements for R1 to see her Optometrist. LPA discovered that there was no driver on the day of the appointment. Based on the investigation conducted, there was sufficient evidence found, proving the above-mentioned allegation to be true. Allegation: Staff did not address a resident's change in medical condition. R1 was admitted to Burbank Retirement Villa East (BRVE) on 7/17/2020. While reviewing the file for R1, LPA discovered that R1 had concerns related to her vision (Right Eye), prior to her admission at BRVE. On the summary report from Emerald Terrace Convalescent Hospital (ETCH), dated 6/26/202, it states “follow up with Ophthalmology due to Right Eye blindness”. While reviewing the Preplacement Appraisal for R1, facility staff documented R1’s vision as “good” and there was no indication regarding vision concerns involving R1. On the physician’s reports dated 7/13/20 and 3/22/22, R1 was listed as not having a visual impairment. During R1’s stay at BRVE, R1 had several appointments with the Optometrist due to decline/change in her vision, yet facility staff failed to update the changes in her medical condition and keeping the appraisal accurate. Based on interviews conducted and record reviews, there was sufficient evidence found, proving the above-mentioned allegation to be true. Based on LPA’s observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report was provided along with the Appeals Rights. The investigation revealed the following; Allegation: Staff do not properly maintain a resident's room. The details of this allegation states that the bedding in resident rooms are foul and rancid and the living quarters in resident rooms are unsanitary. There is a foul smell in bathrooms, dust and garbage underneath resident beds. Based on interviews conducted, the statements obtained were inconsistent and did not corroborate with the above-mentioned allegation. LPA discovered that resident rooms are cleaned daily. During the process, housekeeping will take out the trash, sweep/mop, make resident beds, change the towels and clean the bathrooms. Resident bed sheets are changed once a week or as needed. Interviews conducted did not present concerns of resident rooms being unsanitary. During the visit conducted on 11/29/21, LPA toured resident rooms 206 and 220. During the visit conducted on 8/2/23, LPA toured resident rooms 235, 236, 204, 209, 102 and 108. During both visits, LPA observed resident rooms were clean and sanitary. There was no foul smell inside the rooms or inside the bathrooms. The trash bins were covered with a lid and were empty. The bed sheets and linens were observed to be clean and no dirt or trash was observed underneath resident beds. Based on the investigation conducted, there is insufficient evidence to support the above-mentioned allegation to be true. Allegation: Staff speak inappropriately towards a resident while in care. The details of this allegation states that S1 is verbally abusive towards residents and makes derogatory comments. Based on interviews conducted, the statements obtained were inconsistent and did not corroborate with the above-mentioned allegation. Statements obtained from residents described S1 as being nice and helpful towards residents and denied being verbally abused by S1. During the interview of S1, S1 denied being verbally abusive or making derogatory comments towards residents. Based on interviews conducted, there is insufficient evidence to support the above-mentioned allegation to be true. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. An exit interview was conducted and a copy of this report was provided.