Incident investigation·July 1, 2022

LPAs Jeung and Varilla met with assistant executive director and director of health and wellness to obtain details of incident of 6/11/22 that was reported to CCLD. LPAs reviewed file for client #1 and private companion, who was removed from facility on 6/11/22. LPAs were advised that SF Ombudsman met with facility staff, private companion, and daughter of client to discuss incident. As a result--and based on wishes of DPOA/daughter--private companion is allowed to resume companionship to client as of 6/17/22. Private companion was provided with training by hospice agency on feeding strategies on 6/23/22. Facility documents for private attendants--acknowledgement, indemnification, guidelines--were signed by private companion; copies are obtained. Requirements for Private Duty Attendants and Home Health Agency Personnel and Rules of Conduct of Attendants are also reviewed, but it cannot be confirmed that these documents were given to or acknowledged by private companion of client #1. LPAs recommended that Personal Rights forms LIC613C/LIC613C2 be added to forms that private attendants be required to acknowledge when providing services to facility. No deficiency cited.