complaint·November 6, 2023

Interviews with Staff #4 (S4) indicated that housekeeping staff should be cleaning residents room everyday. Staff #6 (S6) reported to LPAs Brown and Wolcott that only one (1) housekeeping staff works at the facility per day and Staff #7 indicated that First (1) floor of the facility's not clean and sanitary. In addition, interviews with S6 revealed that Staff #8 (S8) who was assigned to clean the first floor of the facility just sits, don't clean and they reported S8 to the housekeeping supervisor but the housekeeping supervisor did not do a thing to address the issue. During the facility visit on 11/06/2023, LPAs Brown and Wolcott toured the facility and observed that residents unkept rooms, not clean rooms, dirty carpets located at the first floor of the facility. Deficiencies will be issued as this pose potential health, safety and personal rights risks to residents in care. The second allegation indicates Facility is in disrepair. LPAs Brown and Wolcott obtained evidence to corroborate the allegation. Interviews with Resident #2 (R2) indicated that the toilet was clogged in Room #103 and flooded Room #104 to Room #119, Resident #10 (R10) reported that their air conditioning unit was leaking and there's water on the floor. Interviews with Staff #4 (S4) indicated that Their Medical Room ceiling was collapsing and their sink was dripping. Moreover, Staff # 6 (S6) reported to LPAs Brown and Wolcott that the bathroom located near the facility's Dining Room was clogged for three (3) to four (4) months now. Also, Staff #7 (S7) reported to LPAs Brown and Woilcott sink leaking, and problem with the facility's vent. During the visit, LPAs Brown and Wolcott observed broken closet door in Room #117. LPA Brown reviewed compliance history and observed that the facility’s issued the same deficiency for the facility not being clean and sanitary and in good repair on 07/14/2023. Civil Penalty was assessed for repeat violations within a 12-month period in the amount of $250.00 per citation and will continue to be assessed of $100.00 per day per citation until corrected. Based on LPAs Brown and Wolcott's observations, interviews and records review, the preponderance of evidence standard has been met, and therefore the above allegation of Staff do not maintain facility in a clean and sanitary condition (Allegation #1), and Facility is in disrepair (Allegation #2) were found to be SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. California Code of Regulations, (Title 22, Division 6 & Chapter 8) is cited on the attached LIC9099D. ***Continuation in LIC9099C *** An exit interview was conducted where this report (LIC9099), LIC9099D,LIC421FC and Appeal Rights were discussed and provided to Assistant Administrator Lauren Calvani. observe mold in Resident #1 (R1) room and during the facility visit on 11/06/2023, LPAs Brown and Woldcott toured the facility and did not observe mold on residents rooms. Based on the evidence, the allegation that Facility has mold is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. An exit interview was conducted where this report, LIC9099 was discussed and provided to Assistant Administrator Lauren Calvani