Complaint·February 14, 2024

CONTINUED FROM FORM LIC9099-A Regarding the allegation that Staff did not have adequate record keeping for resident, the following has been concluded: When a copy of the initial agreement concluded in November 2021 was requested by R1's authorized representative, no copy could be provided per a written staff statement indicaing the document had been misplaced. Following a change of ownership, an updated document was drafted and provided to the authorized representative. The statement corroborates that the facility had incomplete records for R1 that did not meet the requirements of Title 22 regulations. Regarding the allegation that Staff did not provide authorized representative with resident's records, the following has been concluded: Based on email exchanges with the facility including timestamps, it was confirmed that the required maximum of two business days to obtain access to a resident's records upon request was not met after R1's authorized representative requested documents upon R1's discharge from the facility. Two type B deficiencies were cited for failure to meet the requirements of the California Code of Regulations' Title 22 Division 6 on the attached form LIC9099-D. An exit interview was provided and a copy of this report along with appeal rights were provided to a facility representative. CONTINUED FROM FORM LIC9099 Regarding the allegation that Staff did not ensure resident is administered eye drops as prescribed, the following has been concluded: During an interview with R1, R1 stated she often did not receive her medication as prescribed. It is however unclear whether R1 has the ability to make accurate recollection due the primary diagnosis on file. Additional interviews were unable to corroborate that R1's condition had worsened due to a failure to receive treatment. A review of the facility's Medication Administration Records provided for the full period of admission did not evidence instances of missed administration. Regarding the allegation that Staff did not ensure resident was provided a comfortable temperature, the following has been concluded: During a tour of the physical plant, the former resident's shared bedroom was measured to be at an adequate temperature and the thermostat as well as heating operations were shown to be operational. Regarding the allegation that Facility does not have adequate staffing to respond to resident's call in a timely manner, the following has been concluded: An interview with R1 did not evidence issues with staff response time. The facility call system was witnessed to be operational during two tours of the physical plant. Additionally, staff posted schedules and clock punches were reviewed and did not evidence insufficient staffing levels. Regarding the allegation that Staff did not provide resident's authorized representative a copy of admissions agreement, the following has been concluded: When a copy of the initial agreement concluded in November 2021 was requested no copy could be provided per a written staff statement indicated the document had been misplaced. Following a change of ownership, an updated document was drafted and provided to the authorized representative. Regarding the allegation that Staff do not communicate with authorized representative changes of resident's health, the following has been concluded: Based on a review of scheduling documents, staff notes and interviews, it was determined that facility staff reached out to R1's authorized representative after a change in behavior patterns and exit seeking became apparent and a recommendation of a placement in memory care was formulated. Based on these conclusions gathered after review of records, site observation and staff, resident and witness interviews, the five allegations are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid there is no preponderance of evidence to prove the alleged violations did or did not occur. An exit interview was conducted and a copy of this report was provided to a facility representative.