Complaint·August 7, 2025

Based on interview, FR1 corroborated with the allegation and stated on not receiving medication for hypertension to manage his blood pressure from the staff for three to four days while living at the facility. Based on resident interview, one (1) out of two (2) residents denied the allegation and stated on receiving medications as prescribed and had no issues. One (1) out of two (2) residents stated being independent and medication management is not needed from the facility. The Administrator and S1 denied the allegation stating that medication have been provided to FR1 as prescribed. However, based on record review, LPA observed that on the Medication Administration Record for the month of July 2025 provided by the Administrator, FR1’s Metformin 1000MG of 1 tablet 2 times daily, the medication to be taken at 8pm from July 18, 2025, to July 22, 2025, was not initialed by staff. The Administrator stated that the Medication Administration Record provided was due to an error and also stated that there’s another Medication Administration Record that shows that that medication was provided on those dates. LPA requested to see that document. However, the Administrator did not provide the document to confirm that Metformin was given on the date of July 18, 2025, to July 22, 2025, at 8pm during the visit. Therefore, there was sufficient supportive evidence to concur with the reported allegation. Based on LPA's interviews conducted with the residents and staff, the preponderance of evidence standard has been met, therefore the allegation is found SUBSTANTIATED. California Code of Regulations Title 22, Division 6, and Chapter 1 are being cited on the attached LIC 9099D. An exit interview was held with the Administrator, Kaylon Hallman, and a copy of this report and appeal rights were provided. Based on interview, the FR1 corroborated with the allegation stating that the facility only provided the same one meal consisting of sausage. Based on resident interview, two (2) out of (2) residents denied the allegations stating that three meals are provided daily and that there are provided a variety of meals and also mentioned that there was not a time where they were served only sausage or only one meal daily. Based on staff interview, the Administrator and S1 denied the allegation stating that three meals are provided daily. Based on record review, LPA reviewed the facility’s weekly menu which shows three daily meals are provided with a variety of protein such as chicken, beef, and fish. Based on observation, the facility has sufficient food supply including a minimum of 2 days perishable and 7 days non-perishable. The facility kitchen is clean and well-kept and in a operable condition. The food are properly stored in the refrigerator to avoid cross contamination. The freezer had a variety of protein such as chicken, beef, and microwaveable meals. Per Administrator, there are no residents who requires a modified diet that's prescribed by the doctor. There is not enough supportive evidence to concur with the reported allegation. Allegation: “Staff do not ensure resident hygiene needs are met.” It is alleged that the staff are not providing residents showers. Based on resident interview, FR1 and one (1) out of two (2) residents denied the allegation stating that the facility staff did help provide assistance with showers. One (1) out of two (2) residents stated being able to independently take showers and not needing any staff assistance. Two (2) out of two (2) residents also stated not witnessing nor have any concerns of any residents’ hygiene not being met. The Administrator and S1 denied the allegation stating that they provided shower assistance for FR1 when FR1 resided at the facility. Based on record review, LPA reviewed FR1’s daily shower logs from July 18 th , 2025, to July 31 st , 2025, and showers were provided by 8am. The Administrator and S1 also stated that they continue to provide daily shower assistance at the facility. There is not enough supportive evidence to concur with the reported allegation. Based on statements and interviews conducted with staff, residents, review of residents’ files and facility file records, there was not enough supportive evidence to concur with the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was held, and a copy of this report was provided to the Administrator, Kaylon Hallman.