Incident investigation·March 10, 2022

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to obtain information regarding an incident report submitted to Community Care Licensing (CCL) regarding Resident #1 (R1). LPA met with Administrator (Adm) Frances Santillan and stated the purpose of the visit. LPA conducted interviews of Adm, R1, and Police Department during this visit. LPA obtained a copy of R1's Identification and Emergency Information (LIC601), Release of Client/Resident Medical Information (LIC 605), Physician report (LIC602A) dated 7/12/21, Resident Emergency Form dated 3/10/22, Resident Emergency Form dated 7/22/21, Preplacement Appraisal (LIC 603), Durable Power of Attorney (POA) dated 8/1/2007, email between Adm and R1's emergency contact dated 1/21/22, A letter indicating to add a person to R1's contact list to call for emergencies that did not include a date or signature, a copy of the SOC341 and Incident Report submitted to CCL and Long Term Care Ombudsman (LTCO) on 1/21/22, an email between Adm and R1's emergency contact dated 1/19/22 indicating a concern about charges on R1's bank card $2500, on 1/5/22, $3620 (twice) on 1/16/22, Police report dated 1/21/22 filed online, POA for Health Care with Advance Heath Care Directives dated 1/26/22, email between Adm and R1's emergency contact dated 2/8/22 indicating no longer able to pay bills for R1 and has been removed from access. Resident Evaluation dated 2/21/22, a fax to R1's Primary Care Physician indicating very confused requesting a video appointment dated 2/22/22, a fax to CCL indicating a call was received from R1's bank during this visit. A review of R1's physician report indicates that R1 is able to manage own cash resources and able to leave facility unassisted. It also indicates that R1 is confused and/or disoriented. The investigation revealed that a review of all documents mentioned above, the facility has not violated any Title 22 regulations and is working with Adult Protective Services (APS), PCP, and Law Enforcement to ensure R1 remains safe physically and monetarily while residing in the facility. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies are being cited. An exit interview was conducted and a copy of this report was provided.