complaint·April 30, 2024

In regards to the allegation "Residents have fallen multiple times due to staff neglect" it was alleged that residents were falling in the facility due to staff not addressing issues with cracks on the sidewalks. (7) of (7) Staff interviewed denied the allegation. (10) of (10) Residents interviewed could not corroborate the allegation. Interviews with residents and staff noted that residents fall due to other reasons not related to the cracks on the concrete sidewalks. LPA received photos of cracks on sidewalks around the facility. Residents interviewed stated to have no issues with the cracks as they are not large or they can go around them if needed. LPA observed the cracks around the facility. One crack was large but was in an area used for the facilities dumpsters and not a resident walkway. No documentation or interviews showed that residents fell due to the this crack. Based on interviews, file review, and observations; although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. In regards to the allegation "Staff are not meeting residents needs" it is alleged that there is not a sufficient amount of staff to meet resident needs. (7) of (7) Staff interviewed denied the allegation. (10) of (10) Residents interviewed could not corroborate the allegation. Staff interviewed stated they are able to meet the residents needs everyday. Residents interviewed stated they have their needs met and are not aware of which other residents may not be having their needs met. LPA observed sufficient staffing during the 3 separate visits conducted. Based on interviews, file review, and observations; although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. In regards to the allegation "Staff left residents in soiled diapers for an extended period of time" it is alleged that residents are left in wet and soiled diapers for hours. (7) of (7) Staff interviewed denied the allegation. (10) of (10) Residents interviewed could not corroborate the allegation. Residents interviewed who receive assistance with diaper changes stated that staff check in and change them regularly. The residents are also able to contact staff with the call system to request to be changed when needed. LPA was not provided with specific names or times when a resident was left in soiled diapers for extended periods of time. Staff stated to work together to make sure residents are changed and checked on regularly throughout the day. There is a caregiver assigned to each floor throughout the day as med tech staff also assist the residents. LPA observed staff throughout the visit to be assisting residents in need. Based on interviews, file review, and observations; although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Continued on LIC 9099-C In regards to the allegation "Staff are not meeting residents showering needs" it is alleged that staff are conducting showers timely for residents who need that assistance. (7) of (7) Staff interviewed denied the allegation. (10) of (10) Residents interviewed could not corroborate the allegation. Staff interviewed detailed that there is a computer/phone application system that provides the daily assignments on residents who needs showering assistance. Staff interviewed stated they complete the assignments without missing and have not missed any residents showers. Residents interviewed who receive assistance in showers from staff did not have any complaints. There were no specific resident names or times about a resident not being given a shower when needed. Based on interviews, file review, and observations; although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. In regards to the allegation "Staff are not providing a secure way to pay rent" it is alleged that the facility does not provide the residents a secure way to pay their rent. (7) of (7) Staff interviewed denied the allegation. (10) of (10) Residents interviewed could not corroborate the allegation. Interviews with staff stated that residents are able to pay their rent via direct deposits, cash or checks. Whichever method is most comfortable to them. There is also a locked safe area where residents may deposit their payment if they do not want to hand it personally which is always in sight of staff. Interviews stated no one uses it as most people pay direct deposit or hand the administrator or business office manager the check in hand. Many residents will have their responsible parties, usually a family member, make the payments for them as well. Interviews with residents does not show that there is an issue with the methods in which they can pay their rent. Residents interviewed did not express any issue in the security of making their payments. Based on interviews, file review, and observations; although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. Exit interview conducted and a copy of this report was provided. In regards to the allegation "Staff are not logging incidents with residents" it is alleged that the facility does not properly record incidents involving resident incidents and hospitalization's. (7) of (7) Staff interviewed denied the allegation. (10) of (10) Residents interviewed could not corroborate the allegation. Interviews with staff shows that there is a incident/accident report that is filled out by staff whenever an incident occurs in the facility involving the residents. Depending on the situation, the incident is then reported to Licensing , a residents physician, and the residents responsible party. LPA reviewed the facilities internal incident reports and attempted to match them with the incident reports received by Licensing. LPA observed that there are facility incident reports that fall under the reporting requirements set by the department that were not followed. There is an facility incident report dated 6/1/23 of a resident being hospitalized that was not submitted to licensing. There is another facility incident report of a resident threatening another resident dated 12/6/22 not reported to Licensing. This shows the facility failed to properly record incidents in the facility by not following reporting requirements. Based on LPAs interviews conducted, files reviewed, and observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D. Exit interview was conducted and a copy of this report was provided. Appeal rights provided and discussed