complaint·April 15, 2021

Allega tion: " Staff will not give resident access to file." Based on interviews conducted and document review the findings indicate there were three (3) on-site COVID-19 vaccine clinics [ January 20, 2021, February 10, 2021, and March 3, 2021]; in which residents received the Pfizer vaccine. After resident (R1) was fully vaccinated, the resident requested the original Center for Disease Control COVID-19 Vaccination Card, but was not provided the card. Resident (R1) requested the card from former Wellness Director, and caregiver Coordinator staff but was only provided copies of the vaccination card. Resident (R1) was discharged on March 1, 2021 and was not provided the original COVID-19 vaccination card upon discharge. Staff (S3) stated that resident returned at a later date and was given the original card. However facility did not provide proof that resident received the original vaccine card. According to staff interviews, there were changes in Administration staff in February 2021. Former Administrator and former Wellness Director staff were in charge of the COVID-19 vaccine cards. Approximately, two (2) weeks ago the resident's COVID-19 vaccination card records were not found. They were located until the following day. Staff interviews revealed the original vaccination cards were not given to residents. They remained in the possession of Administration staff for safe keeping. Residents only received a copy of the vaccination card. Five (5) out of five (5) residents stated that as of today they have not been given the original COVID-19 vaccination card. According to Title 22, Division 6, Health and Safety Code, Chapter 3.2 Residential Care Facilities for the Elderly, Article 02. Licensing: 1569.153(e) Theft and loss program; standards, property inventories and surrender of personal effects; secured areas. Inventory and surrender of the resident's personal effects and valuables upon discharge to the resident or authorized representative in exchange for a signed receipt. Based on interviews and information obtained the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED . Deficiency is being cited according to California Code of Regulations, Title 22, Division 6, Health and Safety Code, Chapter 3.2, Article 02. See LIC 9099D. A telephonic exit interview was conducted with Administrator Kathleen Olson. A hard copy of the report was emailed. Staff was instructed to sign the LIC 9099 reports and return to LPA.