Incident investigation·December 28, 2023

***Amended on 01/18/2024 to change "See LIC809-D" to "See LIC809-C"*** Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Case Management visit and met with Valerie Alves Care Center Administrator. The purpose of the visit was to address an Incident Report submitted by the facility on 08/17/2023 reporting an incident on 08/15/2023 in which resident R1 stated that three teenage individuals had entered R1's living unit and sexually assaulted R1. The facility had also submitted an SOC341, R1's Physician's Report, the Internal Abuse Investigation Report, and R1's Resident Appraisal. During visit, LPA Marrufo interviewed resident R1, who stated that the incident of sexual assault may have occurred or may have been imagined. R1 stated the facility staff responded to the alleged incident and R1 underwent an evaluation after the incident. LPA Marrufo conducted a telephone interview with R1's Responsible Person (RP1). RP1 stated that R1 has been diagnosed with dementia since the incident and had been re-evaluated. RP1 stated to have been satisfied with how the facility staff handled the incident and believes the facility security is excellent. LPA Marrufo obtained copies of the following documents during visit: R1's Hospital Discharge Report from R1's hospital visit on 08/16/2023, R1's previous and current Service Plan (updated on 08/17/2023), R1's Resident Progresss Notes from 08/16/2023, and R1's Emergency Contact Information Form. R1's Hospital Discharge Report form states that R1's Family Member (FM1) reported to hospital staff that R1 has a history of memory issues without diagnosis and has reported sexual assault in the past. R1's updated Service Plan states that R1's Behavioral Interventions include "Episodes of confusion and delusions." R1's Resident Progress Notes from 08/16/2023 state that "Staff will provide care to resident with 2-person assist to ensure there is a witness at all times. Nurses to monitor resident for 72 hours for any signs of distress." See LIC809-C for more information. Page 1 of 2. LPA Marrufo conducted an interview with staff S1, who stated the facility requires all visitors to check in with the front desk, staff conduct 2 hour checks with all residents, and 2 staff assist R1 with showering, so they will be able to observe R1 for bruising or signs of abuse. No deficiencies were cited at this time as per California Code of Regulations Title 22. This report was reviewed with Valerie Alves and a copy of the report was provided. Page 2 of 2. END REPORT