Complaint·May 16, 2025

Care notes provided by the Administrator showed one resident refusing all oral hygiene, and after discussing refusals with the family, a care meeting was held to explore strategies. The notes state the resident will be encouraged to engage in teeth brushing, but their right to refuse will be respected. Oral hygiene will be offered at alternate times when a refusal occurs—adapting to the resident’s preferences and comfort. No other care notes for September 2024 indicate other residents refused teeth brushing. Staff interviewed stated some residents refuse teeth brushing. Staff indicated they do not keep a written log of residents refusing teeth brushing but make additional attempts. When staff were asked about the morning routine and how they care for residents in the morning, some staff mentioned brushing their hair and washing their face, but did not mention teeth brushing. When prompted to discuss teeth brushing, staff stated if the refusal for teeth brushing is consistent, they will notify the families but would not necessarily notify them if they refuse for an hour and then they are able to brush the teeth at another time. One staff stated a resident’s teeth were brushed twice a day, and another indicated some residents have no issues with getting their teeth brushed. One resident interviewed stated “They have not been brushing my teeth.” Resident’s responsible party confirmed the resident has said that they are not getting their teeth brushed. Another resident stated their teeth are brushed once per week. One resident interviewed stated they had not brushed their teeth since last week. Another responsible party stated their main issue regrading personal care was teeth brushing and it had been an issue for quite some time. The responsible party stated they asked families/visitors of other residents, who also confirmed other residents were not getting their teeth brushed. One responsible party stated if they notice the teeth are not being brushed, they say something to the staff; and the care had improved after bringing up concerns. Responsible party stated staff indicated it was difficult because the resident did not know to spit out the toothpaste due to their dementia. Responsible party stated the breath was really bad, and they bought toothpaste that was non-toxic. Based on the information obtained, the allegation is deemed Substantiated at this time. Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 9099-D): Exit interview conducted. Copy of report and Appeal Rights issued at the time of the visit.