Complaint·June 20, 2023

Based on witness' statements a physical therapist conducted an assessment on 03/30/2023 and R1 did not complain of pain and did not exhibit pain behaviors. Based on witness statements another assessment was conducted on 04/10/2023 a complete head to toe assessment and did not observe any indications of pain or injury. R1 was unable to be interviewed as R1 would not answer LPA Mendivil's questions. The facility staff was unable to confirm if R1 fell on 4/5/2023. Staff reported that if a resident was to fall and complain of pain they would call 911. Staff reported that in this case R1 did not complain of pain in the following days. Due to conflicting information from facility and witnesses it cannot be ascertained whether or not the facility did not seek medical care. Therefore based on the preponderance of evidence through record review and interviews the allegation that Staff did not seek medical care for resident in care is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred. This agency has investigated this complaint. No deficiencies cited. An exit interview was conducted and a copy of this report and confidential names list was provided It was reported that R2 had to go to the hospital and did not return to the facility upon discharge. A report was never received for the incident with R2. Based on interviews with Administrator Brevet Dao Unusual/Serious Injury Report (LIC 624) form was not sent for the incident of R2. Though there is a dispute of a fall occurring with R1, the facility has not followed reporting requirements in a separate incident with R2. Therefore based on preponderance of evidence through record review and interviews the allegation Staff did not follow proper reporting requirements is determined to be SUBSTANTIATED, meaning the complaint allegation is valid and that a violation has occurred. The following is being cited per California Code of Regulations Title 22 Division 6 Chapter 8. An exit interview was conducted and a copy of this report and appeal rights was provided to the facility representative.