complaint·May 15, 2024

During visit conducted on 11/29/2023, LPA conducted an inspection of the facility's required two (2) day perishable and seven (7) day non-perishable food supply on cite. LPA observed multiple open containers, including salad dressing, and multiple expired food items, including yogurt and condiments, in the facility's refrigerator. LPA also observed multiple food containers with prepared food that was not dated or labeled. LPA observed staff member (S1) clean refrigerator and purge expired food items during visit conducted on 11/29/2023. During all subsequent visits to the facility during investigation, LPA observed a sufficient supply of food at the facility. Based on observation, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page. Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents. Interview with relevant party indicated that resident (R1) sustained a burn while residing at the facility. Interviews conducted with Administrator, China Washington, and staff members (S1 & S2) indicated that they never observed R1 sustain a burn mark while residing at the facility. LPA conducted an interview with R1, who could not recall sustaining a burn while residing at the facility. LPA did no observe a burn mark on R1 during interview. A review of R1's hospice records dated 10/1/2023 to 12/12/2023 did not indicate that R1 sustained a burn mark during the time that they resided at the facility. Interview with relevant party indicated that they could not recall requesting documents for R1. Interview with Administrator Washington indicated that any records requested for R1 were provided to the requester within a timely manner. Interview with relevant party indicated that they were allowed to visit R1 while they resided at the facility. Interviews with Administrator Washington, staff members S1, S2, S3, and S4 stated that they are allowing visitation at the facility. All staff interviews indicated that there is a visitor policy allowing visitation between 9:00 AM to 5:00 PM everyday, but accommodations are made for individuals who cannot visit residents during those hours. Interviews with residents R2, R3, and R4 indicated that they are able to receive visitors at the facility. LPA observed a visitor log for visitors to sign at the conclusion of this investigation. Interview with relevant party indicated that activities were not provided to R1 in accordance with their admission agreement. LPA reviewed R1's Admission Agreement, which indicates the following: "We shall offer individualized program of recreational activities based on cooperative planning by facility staff, family, physician, and rapport and communication with the resident. We offer responsive, creative, and fluid planning of recreational activities. Residents and families are interviewed to gather information on their personal preferences, beliefs, culture, values, attention span and life experiences to determine activities that residents will enjoy and benefit from." LPA observed that admission agreement was signed by R1's representative on 10/11/2023. ** Report continued on 9099-C ** During visit conducted on 11/29/2023, LPA observed board games, crossword puzzles, and toys available to the residents. LPA observed books and a television in the residents' rooms. Interviews conducted with Administrator Washington, S1, S2, S3, and S4 indicated that the residents are provide resources for activities and encouraged to participate in activities. Interviews with residents R2, R3, and R4 indicated that they have resources for activities Based on interviews conducted, observations, and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted with Administrator. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.