complaint·September 26, 2023

Continue from LIC9099 The same observations were made during subsequent visits conducted on 8/23/2023, 8/31/2023 and 9/13/2023. Facility management indicated that they were not aware that kitchen staff continued not to be in compliance. During staff interviews, it was indicated that the facility inventory for these items had run out. Management indicated that purchase orders had been placed and was unaware the merchandise had not arrived. On September 13, 2023, management went out to purchase enough supplies and instructed kitchen staff to immediately start using the protective equipment as required. It was also alleged that sufficient staff were not scheduled to meet residents’ needs. Based on the review of the assignment sheets for the months of July and August 2023 it appears that for the most part, there were enough caregivers scheduled to work per shift. However, there were times when caregivers called out and it wasn't clear which caregiver provided coverage on that particular day or if coverage was provided. During a visit conducted on 9/13/2023, 9:45 am, LPA observed that staffing during the morning shift on this day was not sufficient to meet residents' needs. It was observed that there was only one caregiver and one medication technician to meet the needs of 98 residents in Assisted Living. In addition, both the Executive Director and the Resident Services Director were not present at the facility. The Sales Director was also out and not available. There were no management staff present at the facility. During the visit, approximately at noon, the Executive Director arrived at the facility to provide coverage as a caregiver until the staffing level was back to normal during the afternoon shift which started at 2:00 p.m. The Executive Director indicated that they had unanticipated callouts and there were no available caregivers to provide the necessary coverage. The Executive Director stated she was telecommuting doing training and was available via telephone and informed of the staffing situation and came in to provide coverage. The Executive Director indicated the Resident Services Director was out on leave. During staff interviews, it was indicated that the facility was not contracted with a temporary agency for caregivers. In addition, during interviews with staff and outside sources, it was indicated that at times when caregivers call out unexpectedly or are out due to an illness there were no available caregivers in the employee roster to provide the needed coverage. Staff also indicated that caregivers would need to work double shifts due to understaffed conditions. Based on observations on 9/13/2023, the staffing level for care staff was not sufficient to meet the needs of the residents in assisted living. (Continue at LIC9099C) (Continue from LIC9099C) Based on observations, records review, and interviews with staff and outside sources, there was sufficient evidence to support both allegations in this report. The Department has investigated the above-mentioned allegations and has found that there was sufficient evidence to corroborate the allegations. Therefore, these allegations are deemed to be substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met. A Deficiency was cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations and is listed on LIC 9099-D. A copy of this report, LIC 9099D, along with Licensee/Appeal Rights (LIC 9058 03/22) was provided to Executive Director, De La Barre at the end of the visit. (Continue from LIC9099A) During interviews, staff indicated that they normally offered snacks during scheduled activities and upon request. The staff indicated they keep plenty of snack supplies on hand, such as cookies, fruit, crackers, and cheese sticks were always available items upon request. It was also alleged that staff did not meet residents’ hygiene needs. It was specifically alleged that residents were left with soiled briefs for extended periods of time. On August 2, 2023, during a visit, multiple residents were observed in the memory care unit walking or sitting in the common areas to be clean, well-groomed, and wearing appropriate clothing. During individual inspections, six (6) total assist residents' rooms were observed to be clean, organized, and free from bad odors. Although the residents could not be interviewed due to their dementia medical condition, they were also observed to be clean, well-groomed, and free from bad odors. During multiple visits conducted on 8/23/2023, 8/31/2023, and 9/13/2023 the residents were observed clean and well-groomed with no indications of hygiene neglect. Interviews with outside sources disclosed no problems with staff not meeting residents’ hygiene needs. During interviews, staff indicated that residents were checked every two hours for incontinence care and received two (2) showers per week as required in their individual service care plans. It was alleged that staff did not follow reporting requirements. It was specifically alleged that facility management did not report to Community Care Licensing (CCL) when a memory care resident eloped. During the investigation, it was confirmed that there had been a couple of attempted elopements involving one resident. During staff interviews, it was indicated that the resident used to be an assisted living resident and was confused about wanting to go back to assisted living. Facility staff immediately redirected and guided the resident back into the memory care unit. Per Title 22 regulations, attempted elopements are not required to be reported to CCL. During staff interviews, it was indicated that the facility elopement protocols require care staff to report it immediately to management who in turn reports the incident to CCL as required per Title 22 regulations. A review of facility records indicated that the facility’s elopement procedures were in compliance with regulations. The Department has investigated the above-mentioned allegations and based on interviews with staff, residents, and outside sources, the preponderance of the evidence has not been met, therefore, these allegations are deemed to be unsubstantiated. An exit interview was conducted with Executive Director Emily De La Barre, to whom a copy of this report, and the Licensee Appeal Rights (LIC9058 01/16) were provided at the conclusion of the visit.