Complaint·May 13, 2021

Allegation: Resident was sexually abused while in care. – Unsubstantiated. Throughout the investigation, the Department interviewed four (4) facility staff. Interview with staff (S1) indicated that R1 had never notified staff of alleged sexual abuse. Interview with BHN revealed that no allegations of being hit or touched inappropriately were ever brought to their attention by R1. Due to conflicting information, this agency has investigated the above allegation. Although the allegation may have happened or is valid, the Department have found the allegation to be unsubstantiated. Allegation: Resident was physically abused while in care. – Unsubstantiated. On 8/20/2020, the facility called Roseville Police Department and reported the information of R1 being physically abused by facility staff. Roseville PD called the facility and notified ED that there were no sign or injuries and community has taken all precautions. Due to R1 having diagnosis of dementia Roseville PD did not take a criminal report but responded to the allegations under mandated reporting requirements. Due to conflicting information, this agency has investigated the above allegation. Although the allegation may have happened or is valid, the Department have found the allegation to be unsubstantiated. Allegation: Facility staff did not notify resident’s authorized representative of incident. – Unsubstantiated. According to Executive Director, Sherrie Kuar, R1’s POA notified the facility of R1’s physical abuse. R1 notified R1’s POA that a man was hitting R1. ED stated R1 did not notify facility staff of the physical or sexual abuse. ED stated once the incident was brought to her attention, she notified corporate, submitted an incident report to CCL, filed a SOC341, and called law enforcement. Allegation: Resident is not being properly treated for lice. – Unsubstantiated. On 8/7/2020, Brookdale Roseville submitted an Unusual Incident/Injury Report to Community Care Licensing (CCL). The report indicated that (S1) had discovered R1 had head lice on 8/3/2020. Bristol Hospice was contacted immediately for head lice treatment orders. Head lice treatment order was received the same day and started immediately at 3:00pm. The same day at 3:30pm, R1’s POA was notified via telephone. Executive Director initiated facility’s head lice policy. R1 was placed under observation to monitor effectiveness of head lice treatment. R1 was quarantined and placed under isolation until head lice resolved. The facility had initiated 1:1 for R1 for isolation due to R1 being restive to being quarantined in room. All community residents and staff were checked for head lice and were cleared. No other cases of head lice were reported except for R1. ********** Continue on LIC 9099-C ********** On 8/6/2020, it was discovered that R1’s first treatment of Permethrin Lotion 1% was not effective. Facility contacted Bristol Hospice and notified R1’s Physician of ineffective medication. R1’s Physician changed the prescription and R1 was started on Dexamethasone treatment until 8/16/2020. Interview with R1’s Physician indicated that R1 had a reoccurring infection which took longer to treat. R1’s Physician stated recommendations were given to the facility but does not have any knowledge if facility had followed them or not. Interview with Bristol Hospice Nurse indicated that to their knowledge facility’s staff has been following physician orders for treating R1’s head lice. Allegation: Facility staff did not ensure that resident’s room was free of hazards. – Unsubstantiated. On 8/17/2020, LPA Keosavang and Leitzell conducted an unannounced visit at the facility to ensure there are no health and safety concerns. LPAs toured the interior and exterior of the facility with Med-Tech (MT1). Due to COVID-19 and pre-cautionary measures LPA did not enter R1’s bedroom. LPAs observed R1’s bedroom from the door. Passageways were free of obstruction. LPA observed a couple boxes on the bedroom floor. This agency has investigated the above listed allegations. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred therefore, we have found the allegations to be UNSUBSTANTIATED . An exit interview was conducted with Executive Director, Sherrie Kuar, and a copy of this report will be provided to the facility via email. The report is to be signed and returned to LPA via email.