Complaint·March 16, 2021

On 02/11/2021 at 3:49pm, LPAs interviewed resident (R9) and observed a Styrofoam box of food labeled with resident's room number. Box contained an uneaten piece of chicken. R9 requires a diet of semi-solid foods with thickened liquids as outlined in the service plan agreement and hospice care plan. The food observed was not prepared per R9’s dietary requirements. On 2/11/2021, LPAs interviewed 3 residents. 3 out of 3 residents interviewed stated they or their spouse had special diets, but that special diets were not prepared per the resident's needs. Records review of meal prep records did not reflect R9’s required diet. The records confirmed that R13 has a nut food allergy. On 02/19/2021, 3 kitchen staff S9-S11 interviewed stated that food was prepared per resident’s dietary restrictions. LPAs reviewed a report from the Santa Cruz Public Health Department Report dated 1/7/2021. The report states that during site visit conducted on 1/6/2021, several resident rooms were blocked off by a barricade. The facility was trying to keep COVID positive wanderers in their rooms. Residents housed in the barricaded rooms were later moved to the memory care unit. Photograph confirmed a barricade at the entry of a resident room. Staff confirmed residents' rooms were barricaded. The Department has conducted an investigation of the above allegations. Based on LPAs’ interviews, observations and record review, the preponderance of evidence standard has been met. Therefore, the Department found the above allegations to be SUBSTANTIATED . Deficiencies cited per the California Code of Regulations Title 22, see attached 9099D. Report reviewed with Tami Ojwang, General Manager, and a copy of this report provided electronically with appeal rights for signature. 10 out of 16 residents interviewed stated that they were given multiple options as to what they wanted to eat and that substitutions were available in the case that they did not want either option. 6 out of 10 were unable to answer the question. Food service records note variety of foods provided with options available to the residents. 13 staff out of 13 interviewed in regards to food service stated that food service was prioritized during the COVID-19 outbreak and that all residents were served and assisted with meals as needed. LPAs reviewed the record of R13. Meals provided to resident and depicted in photographs were in accordance with dietary restrictions outlined in physician's report and doctor's notes. The Department has investigated the above allegation. Based on interviews conducted, records reviewed and photographs, the Department found that the above allegation is UNSUBSTANTIATED . An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation did or did not occur. Report reviewed with Tami Ojwang, General Manager, and a copy of this report provided electronically for signature.