Complaint·December 12, 2024

(continued form 9099) In July of 2021, it was reported to Community Care Licensing Division (CCLD) that the Licensee representative spoke improperly about death to the reporting party, not to R1. Interviews with staff and outside sources were not able to provide any information to support or deny the complaint allegation. The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has not been met, therefore, this allegation is deemed unsubstantiated. An exit interview was conducted with Executive Director XXXX, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22). (continued from 9099) According to regulation CCR 87468 (titled "Personal Rights"), Licensee was required to provide “safe and healthful living accommodations.” In July of 2021, it was reported to Community Care Licensing Division (CCLD) Resident #1(R1)(See LIC 811 for confidential name) had ants crawling on their person and their bedding while residing in the memory care unit (Generations) of the facility. The Department was able to locate individuals who had been present at the facility during the time period identified in the complaint allegation. Interviews with outside sources and staff revealed ants were present inside the memory care unit of the facility during the time identified in the complaint allegations. Interviews with staff and an outside source revealed they observed R1 to have ants crawling on their person and in their bedding. The Department has investigated the allegation that Licensee did not provide healthful accommodations for resident and has found that, based upon evidence found during interviews and record review, the preponderance of the evidence standard has been met. Therefore, this allegation is deemed substantiated. This deficiency is noted on the attached 9099-D and is cited in accordance with the California Code of Regulations, Title 22. A copy of this report, along with Licensee/Appeal Rights, An exit interview was conducted with Executive Director XXXX, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).