complaint·July 6, 2022

The investigation revealed the following: In regards to the allegation, "Staff did not provide a copy of the admission agreement " it was alleged that the facility staff did provide an copy of R1's admission agreement when requested by family. (5) of (5) staff interviewed denied the allegation. (4) of (5) residents could not corroborate the allegation. Interviews show that a copy of R1's admission agreement was requested by relatives of R1 and were not provided by staff. Interviews show that R1 provided the facility staff with a letter stating that R1 gives their relative permission to receive such information. LPA observed the letter on file which was dated on 9/28/21. LPA's initial visit was conducted on 12/2/21 where the admissions agreement had yet to be provided to the relative that requested the agreement, this shows that the staff failed to provide the admissions agreement when requested. In regards to the allegation, "Facility has inadequate record keeping for the residents" it was alleged that the facility could not provide a breakdown of R1's current pay rate as stated in the admissions agreement. (5) of (5) staff interviewed denied the allegation. (4) of (5) residents could not corroborate the allegation. Interviews show that R1's pay rate according to their admissions agreement Schedule A is $1300. Interviews state that R1's rate was calculated by adding $1200 as the base monthly fee and $100 for assisted living level of care rate. R1 has been receiving medicine management since they were admitted and that is defined as "level 1" care in the admissions agreement. R1's admissions agreement on file does not show the breakdown of the 1300 explained during interviews and staff interviewed were not able to explain why it did not show on the admissions agreement. Due to this discrepancy, the facility failed to have adequate record keeping of R1's file. Based on interviews conducted, the preponderance of evidence standard has been met, therefore the allegation(s) are found to be substantiated. California Code of Regulations, Title 22, citations are being cited on the attached LIC 9099D. A copy of this report was provided to Administrator Pamela Junge. Appeal rights were discussed and provided. The investigation revealed the following: In regards to the allegation, "Staff not abiding to admission agreement" it was alleged that the facility is raising the rate for R1 and did not provide a notice as required. (5) of (5) staff interviewed denied the allegation. (4) of (5) residents could not corroborate the allegation. Interviews show that R1 was provided a 60 Day notice of the rate change in August 2021 prior to the new rate taking place on November 2021. LPA reviewed R1's file and observed the notice dated and signed by S1. Based on observations, interviews and files reviewed there was not enough supportive evidence to corroborate with the reported allegation. In regards to the allegation, "Staff did not advise residents of complaints filed against the facility " it was alleged that the staff did not inform residents of complaints against the facility. (5) of (5) staff interviewed denied the allegation. (4) of (5) residents could not corroborate the allegation. Interviews do not show that staff inform residents of complaints on the facility but licensing reports are posted with other required postings for residents to see. Review of title 22 regulations do not state that staff need to inform residents of complaints filed against the facility. Based on interviews and file review conducted, there was not enough supportive evidence to corroborate with the reported allegation. In regards to the allegation, "Resident is being charged for services not received " it was alleged that R1 is not being provided the services required per the admissions agreement. (5) of (5) staff interviewed denied the allegation. (4) of (5) residents interviewed could not corroborate the allegation. Interviews show that R1 receives assistance with medication, is provided 3 meals a day, has help with laundry, and has their room cleaned by staff. Review of R1's file does not show other services being paid for and not provided by the facility. Based on observations, interviews, and files reviewed, there was not enough supportive evidence to corroborate with the reported allegation. Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation(s) are UNSUBSTANTIATED. Exit interview was conducted and a copy of this report was provided to Administrator Pamela Junge