complaint·December 22, 2022

During the course of this investigation, LPA reviewed resident R1’s: Physician reports (LIC 602), Medication Administration Records (MAR), hospice care notes, needs and service appraisal, charting notes, staff training records, time sheets, call button reports and records from the Vacaville Police Department. In addition to reviewing resident and staff documentation, LPA made observations and conducted interviews with staff, Previous and Current Administrator, Hospice Health Agency, Responsible Parties and Residents. The following determinations were made based on the information gathered: Interviews and records reveal that there were no witnesses to the alleged abuse. Statements from interviews reveal that on 9/3/22 a red mark appeared on the left side of R1's face. (pictures taken). Pictures taken by staff dated 9/3/22 indicate that R1 had dryness and red discoloration on the left side of their face. There were conflicting statement of what may have caused the red discoloration/rash to appear on R1's face. A day prior to the discoloration/rash appearing on R1's face, R1 received was bathed by a home health aid and according to R1's (602) Physician Report and statements from the Hospice agency R1 has significant skin breakdown, and dryness of the skin, which could've resulted in R1 having a rash/skin breakdown on their face. Once the discoloration was observed the facility ensured that the hospice agency and the responsible parties were made aware. Therefore, LPA was unable to determine what caused the skin discoloration and if there was any physical abuse that occurred. A finding that the complaint allegation: Staff abused resident in care is UNSUBSTANTIATED, meaning that although the allegations may have happened there is not a preponderance of evidence to prove that the allegations occurred. No deficiencies cited during this visit.