complaint·March 24, 2023

Interviews conducted with residents R1, R2, R3, R4, R5, R6, and R7, staff members S1, S2, S3, S4, S5, S6, S7, S8, and S9, and ED indicated that there have been no incidents witnessed in which a resident was threatened by facility staff. Allegation: Facility is not releasing records to residents Interviews conducted with residents R1, R2, R3, R4, R5, R6, and R7, staff members S1, S2, S3, S4, S5, S6, S7, S8, and S9, and ED indicated that there have been no incidents witnessed in which a resident requested for copies of their records from the facility and did not receive them. Allegation: Facility is not treating residents with dignity Interviews conducted with residents R1, R2, R3, R4, R5, R6, and R7, staff members S1, S2, S3, S4, S5, S6, S7, S8, and S9, and ED indicated that there have been no incidents witnessed in which a resident was not treated with dignity by facility staff. Allegation: Facility did not give proper documentation to resident's physician Interviews conducted with residents R1, R2, R3, R4, R5, R6, and R7, staff members S1, S2, S3, S4, S5, S6, S7, S8, and S9, and ED indicated that there have been no incidents witnessed in which emergency medical services did not receive the necessary documents needed when a resident was transferred from the facility to the hospital Allegation: False claims Interviews conducted with residents R1, R2, R3, R4, R5, R6, and R7, staff members S1, S2, S3, S4, S5, S6, S7, S8, and S9, and ED indicated that there have been no incidents witnessed in which the facility presented false claims regarding services the facility provides or services the residents receive. ** Report continued on 9099-C ** Based on interviews conducted, 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 Executive Director and a copy of this report was provided to the facility. The signature of the Executive Director on these forms acknowledges receipt of these documents. During inspection conducted on 1/31/2023, LPA conducted a medication count for residents R8, R9, and R10, comparing each resident’s Centrally Stored Medication Form (CSM) with medications centrally stored for the resident. LPA observed that every medication counted for R8 was off count in relation to what was documented, including both under and over the amount documented. 1 medication for R8 had more tabs in the bottle than the quantity documented. No missed or refused medications were documented to account for the medication errors for R8. Medications for R9 and R10 did not demonstrate any medication errors. Based on interviews conducted by the department, records reviewed, and medication count, the preponderance of evidence standards have been met. Therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 9099-D page. Exit interview was conducted with ED. A copy of this report and appeal rights were provided. ED's signature on these forms acknowledges receipt of these documents.