complaint·September 8, 2021

at a later date. It was also revealed that shortly after the time of the lift assist from the fire department the resident’s hearing aid went missing and was unable to be located. Hearing aid was documented on R1's inventory list upon move in, R1 moved out the beginning of April 2021 and the hearing aid was never located. Documentation reviewed revealed that R1 had a fall on or around 11/24/2020 with no injuries noted which was not reported to the department. R1 experienced a similar incident on 11/13/2020 which was reported to the department on an incomplete incident report. The department received an incident report on 03/25/2021 notifying the department that R1 had been issued an eviction notice however no copy of the notice was received until it was later requested, upon review it was found to be incomplete and therefore not valid. Due to this information the department finds the allegations to be SUBSTANTIATED, a finding that the complaint is Substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. The following deficiencies are cited on the attached LIC 9099-D: §1569.152 Safeguard of resident property; reimbursement for failure to make reasonable efforts; preseumption; penalty (a) A residential care facility for the elderly, as defined in Section 1569.2, which fails to make reasonable efforts to safeguard resident property shall reimburse a resident for or replace stolen or lost resident property at its then current value. The facility shall be presumed to have made reasonable efforts to safeguard resident property if the facility has shown clear and convincing evidence of its efforts to meet each of the requirements specified in Section 1569.153. The presumption shall be a rebuttable presumption, and the resident or the resident's representative may pursue this matter in any court of competent jurisdiction. 87211 Reporting Requirements (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. (D) Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. Report Continued on LIC 9099-C §1569.683 Eviction notices; reasons for eviction contents; service (a) In addition to complying with other applicable regulations, a licensee of a residential care facility for the elderly who sends a notice of eviction to a resident shall set forth in the notice to quit the reasons relied upon for the eviction, with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. In addition, the notice to quit shall include all of the following: (1) The effective date of the eviction. (2) Resources available to assist in identifying alternative housing and care options, including public and private referral services and case management organizations. (3) Information about the resident's right to file a complaint with the department regarding the eviction, with the name, address, and telephone number of the nearest office of community care licensing and the State Ombudsman. (4) The following statement: "In order to evict a resident who remains in the facility after the effective date of the eviction, the residential care facility for the elderly must file an unlawful detainer action in superior court and receive a written judgment signed by a judge. If the facility pursues the unlawful detainer action, you must be served with a summons and complaint. You have the right to contest the eviction in writing and through a hearing." Exit interview conducted, appeal rights provided, and copy of report to be emailed to administrator. Documentation reviewed showed that an inventory list was completed and signed by R1's responsible person shortly after admission, however interviewed conducted allege that it was not always updated as new items were purchased. Centrally stored medication log reviewed showed that R1 started a new medication shortly after arriving at the facility, the medication was logged and the medication was centrally stored and dispensed as ordered according to interview with facility administrator. Text message correspondences reviewed reveal that there was a possible shortage of the medication however the cause is unknown. According to facility administrator there was not a shortage, the medication was refilled timely by the pharmacy, and R1 never missed a dose. No documentation reviewed revealed that the resident's needs were not met, however interviews regarding staff being able to meet resident's needs resulted in conflicting information. Due to this information the department finds the allegations to be UNSUBSTANTIATED a finding of unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview conducted and copy of report emailed to administrator.