Complaint·September 13, 2021

Resident fell while in care Based on staff interviews, 4 out of 4 stated that they did not hear resident (R1) fall out of bed. All staff stated they found R1 already on the floor at around 8am on 02/19/21. One staff stated R1 was last checked around 7:10am that day while staff was doing rounds on the residents and R1 was awake and laying on the bed. Licensee did not provide medical assistance in a timely manner From staff interviews, 4 out of 4 staff stated that licensee was notified when R1 was found on the floor around 8am on 02/19/21. Temporary staff stated that they called the licensee several times that day as soon as they found R1 on the floor. During licensee’s interview, licensee stated that she was notified of the incident around 8am that day. Licensee then notified the hospice nurse (RN) of the incident so they can check R1’s condition. Afterwards, licensee instructed the two temporary staff to take turns watching R1 until RN arrived at the facility. Licensee stated that RN called her after the visit and notified her that R1 was fine, was not in pain, there was no bruising, no bleeding, R1’s vitals were good and that R1 responds to RN. Licensee also stated that when the temporary staff notified her the next day that R1 has some bruising on the right leg, licensee called and reported the bruising to RN and was advised to ice the leg 3x a day. On 05/17/21, LPA interviewed RN. During the interview, RN verified a call from the licensee was recorded on 02/19/21 at 8:49am to notify RN about the incident with R1. RN stated R1 was visited and checked the day of the report. The department has completed the investigation of the above allegations. Based on interviews and records review, there is no preponderance of evidence to prove the allegations did or did not occur. Therefore, the Department found the above allegations to be UNSUBSTANTIATED . No citations were issued per the California Code of Regulations, Title 22. Report was reviewed and a copy provided to Rosalia Calungcagin.