complaint·March 3, 2023

Allegation: “Staff are mismanaging residents’ medication.” It is alleged that staff are mismanaging residents’ medications according to residents needs.” Five (5) out of the five (5) Staff (S1 – S5) interviewed, deny this allegation. Three (3) out of the four (4) residents (R2 – R4) interviewed, denied staff mismanaging their medications. LPA reviewed medication orders for R1 however, due to R1 no longer being at the facility, LPA could not verify Medication Administration Record (MAR) from 05/01/2021 through 06/30/2021. At 2:25 pm, LPA Ramirez observed S4 pushing medication cart through facility hallway and stopped at near by resident room to administer medication. LPA observed S4 to be wearing gloves, and a surgical mask while administering medication to resident. A pitcher with a clear liquid was also observed on the medication cart. Allegation: “Staff are not providing adequate food service.” It is alleged that food is being improperly handled by staff. Five (5) out of the five (5) Staff (S1 – S5) interviewed, deny this allegation. Three (3) out of the four (4) residents (R2 – R4) interviewed, denied staff are not providing adequate food service. LPA Ramirez conducted kitchen tour at 10:45 am while kitchen staff was preparing lunch. Kitchen staff were observed wearing hair nets and gloves while preparing food. LPA Ramirez verified Food Handler Certifications for three (3) of the kitchen staff that were present. At 12:07 pm, LPA Ramirez observed kitchen wearing gloves and hair nets while plating dishes and placing meals on dining cart. LPA observed servers wearing gloves and hair nets while serving meals to residents’ tables. Allegation: “Staff did not safeguard residents’ belongings.” It is alleged that staff did not safeguard residents’ belongings. Five (5) out of the five (5) Staff (S1 – S5) interviewed, deny this allegation. Three (3) out of the four (4) residents (R2 – R4) interviewed, denied staff did not safeguard residents’ belongings. At 11:37 am, while LPA Ramirez and Administrator Sanchez were conducting tour, LPA overheard R2 telling staff that R2’s hamper was missing from their room. LPA Ramirez observed Administrator Sanchez and another staff, go into R2’s to try and locate the alleged missing hamper. Administrator Sanchez and staff found the hamper in R2’s room. The hamper had been moved to a different area of the room by staff, to clean R2’s room. Allegation: “Staff did not prevent resident from making inappropriate comments towards another resident.” It is alleged staff did not prevent resident from making harassing comments towards resident. Five (5) out of the five (5) Staff (S1 – S5) interviewed, deny this allegation. Three (3) out of the four (4) residents (R2 – R4) interviewed, denied staff did not prevent resident from making inappropriate comments towards another resident. Although three (3) out of the four (4) residents deny this allegation, they confirm having hearing and seeing residents say inappropriate comments to each other but, residents (R2 – R4) all confirm staff will immediately redirect involved residents’ and diffuse the situation. Allegation: “Staff did not seek medical attention for resident.” It is alleged staff did not seek emergency medical attention for resident R5 on or about 06/15/21. Five (5) out of the five (5) Staff (S1 – S5) interviewed, deny this allegation. Three (3) out of the four (4) residents (R2 – R4) interviewed, denied staff did not seek emergency medical attention for resident in care. LPA verified resident R5 Special Incident Report (SIR) and could not find any pertinent documentation that suggests R5 required immediate emergency services on or about 06/15/21. Allegation: “Facility phone is in disrepair.” It is alleged facility phone is in disrepair and unable to receive voicemails. Five (5) out of the five (5) Staff (S1 – S5) interviewed, deny this allegation. Three (3) out of the four (4) residents (R2 – R4) interviewed, denied facility phone was in disrepair. At 11:11 am, LPA Ramirez observed a telephone located on second floor of facility community room. A second telephone was observed on the first floor of the lobby area. LPA picked up receiver of phones and heard dial tones. LPA tested phones and observed both phones to operable. 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. Exit interview held, and a copy of this report was provided.