complaint·August 22, 2025

Additionally, LPA Lee interviewed 6 out of 6 family members and friends of residents. None expressed concerns regarding incontinence care, and all reported that their loved ones are regularly changed by care staff. They also stated that they have not observed their loved ones in soiled or unclean incontinence briefs. Interviews were also conducted with 5 out of 5 residents, all of whom stated that their incontinence care needs are being met by the facility staff and expressed no concerns. During a facility observation on 07/30/2025, no signs of incontinence odor were detected. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff do not ensure residents incontinent care are being met. It was alleged that staff do not allow residents to eat their meals in a comfortable manner. The investigation included interviews with staff, residents, responsible parties, and direct observations. LPA Lee interviewed all five facility staff members. Each staff member denied the allegation and reported that lunch is typically served between 11:30 AM and 1:00 PM. LPA Lee also interviewed six out of six family members and friends of residents. None of them expressed concerns about residents being unable to eat their meals comfortably. They reported regularly sitting with their loved ones during mealtimes and stated that meals are not rushed. They felt residents are given sufficient time to eat and shared that facility staff are often seen sitting with and assisting residents who may need more assistance with feeding. Additionally, interviews were conducted with all five out of five residents. All residents reported no concerns regarding mealtimes. On 7/30/2025, at approximately 11:15 AM, LPA Lee conducted a tour of the memory care unit. During this observation, care staff were seen assisting residents in the dining area. Lunch service began at around 11:20 AM and continued until approximately 1:00 PM. Throughout the observation, LPA Lee observed a calm and unhurried dining environment, where residents were given adequate time to eat. Five care staff were observed assisting residents with their meals, while two med-techs distributed medications. Approximately 29 residents were present in the dining room during this time. Resident 1 (R1) was observed receiving assistance with their meal but later declined further help from staff. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff do not allow residents to eat their meals in a comfortable manner. It was alleged that staff do not ensure residents are treated with dignity and respect regarding their health conditions. CONTINUED LIC 9099-C The investigation included interviews with facility staff, residents, responsible parties, and direct observations. LPA Lee interviewed all five facility staff members. Each staff member denied the allegation, stating that residents are treated with dignity and respect. LPA Lee also interviewed six out of six family members and friends of residents. None expressed concerns about how staff treat residents. One friend of a resident stated, “They are loved here.” Another shared that they have no concerns about the care their loved one receives. A third individual noted they have visited their loved ones’ room and observed staff providing care in a kind and respectful manner. All family members and friends of residents stated that they have not witnessed any incidents of staff treating residents without dignity or respect, especially regarding residents’ health conditions. Additionally, five out of five residents interviewed reported no concerns about how they are treated by staff in relation to their health conditions. Based on interviews and statements conducted during the investigation process as well as direct observations, LPA Lee was unable to corroborate the allegation that staff do not allow residents to eat their meals in a comfortable manner. The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are 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(s)occurred. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, no deficiencies were cited. A copy of this report was provided at the end of the visit.