complaint·October 20, 2023

The ED also stated there was one (1) caregiver and one (1) Medication Technician on NOC shift, and an AM staff that starts at 5:00am to assist NOC shift for one (1) hour before their shift ends. Staff interviews revealed it’s impossible to get all multiple up by breakfast if they start at 5:00am. Therefore, staff must start waking residents up as early as 3:00am to fulfill the facility’s requirement of getting the residents up and ready. Staff interviews confirmed they wake the residents up at 3:00am-3:30am to get them ready and the residents are placed in the dining room area and are falling asleep, while they wait for breakfast to be served. Residents sleep is being interfered by staff due to waking up as early as 3:00am to get ready for a 7:30am breakfast. Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation was found to be substantiated. California code of Regulations, Title 22, Division 6 & Chapter 8 is cited on the attached LIC 9099D. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Executive Director, Suzette Johnson whose signature below confirms receipt of these rights. It was also alleged staff do not maintain the facility in clean condition. It was reported Room #101’s carpet had blood stains and other carpets were dirty as well and not being shampooed or cleaned. On 09/06/23, LPA observed Room #101 and observed stains on the carpet along with a strong odor. The odor was intense causing the LPA to have to exit the room quickly. LPA observed other resident rooms and discovered stains and strong odors. LPA also observed all resident hallways had new flooring as the carpets were already replaced. Staff interviews revealed they had gotten used to the smell/odors, which were caused by the old carpets. Staff also confirmed the carpets were being replaced by the new owners. The Executive Director’s (ED) interview revealed the carpets were not in clean condition and needed to be replaced. The ED explained the facility had new ownership and she was new as well but was already working on replacing all the carpets with flooring. The ED explained there was a delay with replacing all the carpets with flooring due to some issues with the contractor. However, everything was now on track and Room #101’s carpet was next on the list to be replaced. All residents have a Major Neurocognitive Disorder and did not witness odors in their rooms. The ED provided proof of documentation that all resident carpets were being replaced with flooring. In addition, the ED also provided documentation to show the timeline and delays with the contractors. The ED was able to prove the work began when they took over ownership, and time was needed to replace all the carpeting. Today, LPA confirmed all residents room carpets have been replaced with flooring. 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 allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Executive Director, Suzette Johnson whose signature below confirms receipt of these rights.