Complaint·March 26, 2024

The ED used the sticky note and covered the camera with R1’s permission. R1’s Physician Report dated 11/22/01 indicated a diagnosis of Major Neurocognitive Disorder, and was confused and disoriented, and unable to leave the facility unassisted. Due to R1’s diagnosis it’s unknown if R1 understood the camera was being covered. Outside source interviews confirmed R1 did not know how to operate the laptop due to their medical diagnosis. Outside sources stated the camera was always on so that the family could contact R1, since R1 didn’t know how to operate it. Additional outside sources revealed the facility did not have consent to cover the camera on the laptop, as that was how the family communicated with R1. When the family tried to contact R1 via camera on the laptop they were unable, due to the camera being covered. Therefore, the family member went to the facility and discovered a piece of tape was placed over the camera. Due to R1’s medical diagnosis and not being able to provide consent, the facility needed to discuss the issue with the responsible party prior to covering the camera. The ED explained the staff were uncomfortable being recorded and didn’t want to provide medications. Therefore, he asked R1 for consent to ensure staff felt their privacy was protected. It was also alleged, a resident was not provided with safe equipment. R1 was provided with a wander guard bracelet that alarms if R1 exits the building. The safety feature was in place due to R1’s medical diagnosis and not residing in the locked memory care unit. The wander guard does not prevent a resident from eloping but alerts staff so they may intervene. According to staff, if R1 exited the building, a notification was sent to the staff’s iPad, a notification to the concierge, and a loud sounding alarm for all to hear. Staff interviews confirmed R1’s wander guard was inoperable but for an unknown time. A review of correspondences indicated the facility was made aware of the inoperable equipment on 02/12/22 and the facility responded on 02/14/22 stating a new wander guard was requested, and being programmed, they will cut the existing one off and replace it. On 02/15/22, R1’s family member was visiting R1 when a staff member entered the room to replace the inoperable wander guard. The wander guard was inoperable for approximately three (3) days, which was unsafe for R1 due to their medical diagnosis. Based on interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8, are being cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Memory Care Director, Marie Lou Fikingas whose signature below confirms receipt of these rights. During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation was deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) was provided to Memory Care Director, Marie Lou Fikingas whose signature below confirms receipt of these rights.