Complaint·December 13, 2023

This is an amended copy of the report previously issued on 12/13/2023. After review of this complaint, it was determined corrections to the verbiage was warranted. The complaint findings remain the same. preplacement/resident appraisal, Appraisal needs and services plan, personal rights of the residents, physician progress reports, consent forms. LPA did not observe the resident records to be incomplete and inaccurate. The LPA attempted to interview five (5) out of five (5) residents, but due to their inability to communicate with words, that could not be completed. Regarding the allegation: Facility failed to maintain a complete and accurate staff records. It is being alleged that the staff records were not complete and accurate.LPA reviewed all personnel record, health screening with TB test results, CPR/first aid, employee rights, statement acknowledging requirement to report suspected abuse of dependent adults and elders, criminal background and in service/training. All records were observed, reviewed and copies were obtained. The LPA did not observe the staff records to be incomplete and/or inaccurate. The LPA was able to interview four (4) staff. Regarding the allegation: Facility is in disrepair. It’s being alleged that the physical plant is in disrepair.LPA conducted a physical plant tour of the facility at 9:45a.m. There is a total of seven (7) bedrooms. Six (6) bedrooms is used for residents (single occupancy). The resident's room was equipped with proper bedding and lighting. There is a total of three (3) bathrooms. There is also smoke detectors and carbon monoxide detectors throughout the house in working order. There is a backyard that has a shaded area and seating for all residents. During interview with staff, staff did not report any disrepair with the facility. LPA did not observe the physical plant to be in disrepair. Regarding the allegation: Facility staff failed to properly administer resident’s medications. LPA reviewed all five (5) resident medications and Medication Administration Records (MAR). Records were reviewed and were observed to be properly distributed according to the medication record. The LPA observed the bubble packs to have the accurate date and were properly dispensed. The AM, PM and bedtime were administered up to/leading to 12/13/23. There was also PRN- (as needed medication) in bubble packs. The medication was labeled per resident name in separate binders, stored and locked in a cabinet inaccessible to the residents. LPA did not observe the resident medication to not be properly administered. Based on the LPA's interviews, observations, and record reviews all four allegations above are unsubstantiated at this time. All copies of records/files were obtained. An exit interview was conducted, no citations were issued for the four (4) above allegations, and a copy of this report was given to the administrator. This is an amended copy of the report previously issued on 12/13/2023. After review of this complaint, it was determined corrections to the verbiage was warranted. The complaint findings remain the same. LPA spoke to the Licensee to verify how many staff are working on the weekend and overnight. Licensee stated, ‘there is no staff that work overnight. They have live-in staff in case anything goes wrong.” LPA conducted a record review which indicated resident with dementia are currently in care at the facility. Based on LPAs observations, interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter 6), are being cited on the attached LIC-9099D.”) when there is care of residents with dementia Night Supervision, a facility with fewer than 16 residents shall have at least one night staff person awake and on duty. There are currently three (3) residents out of five (5) residing at the facility with a current diagnosis of dementia. An exit interview was conducted, citation given, appeal rights, and a copy of this report was given to the administrator.