complaint·April 25, 2022

Regarding the allegation "staff failed to observe changes in resident's health:" Assisted Living Resident Assessment dated 06/09/2020 indicates R1 requires 1-person assist with bathing, 1-person assist with dressing, grooming reminders, stand-by assistance with toileting, 1-person escort to and from activities, and 1-person assist with transfers, as well as medication assistance. Needs and service plan for R1 dated 09/03/2020 indicates total assist with dressing and grooming, 2-person assist with bathing, toileting, ambulation and transfers, as well as R1 is a fall risk and requires total assist with medications. Although the new needs and service plan does indicate a change in condition, the plan is not signed by the resident nor the resident’s responsible party so there is no indication this change of condition was communicated to R1’s responsible party nor R1's physician. On 08/19/2020, charting notes indicate R1’s tremors seem to be worsening and MD notified. Faxed note indicates “family notified,” however the note indicating “family notified” does not indicate who was told or when. Physician communication reviewed contained faxed notes to R1's physician, but none prior to 11/12/2020, during the time period of the complaint. Interview with resident’s responsible party revealed that the responsible party was not contacted nor made aware by the facility that R1 had a change in condition. Interview with Administrator on 12/17/2020, revealed that at the time of the complaint the facility was short-staffed and that communication with families and other pertinent parties was delayed at that time due to the staffing issues. Therefore, based on interview and record review, the allegation that "staff failed to observe changes in resident's health" is deemed SUBSTANTIATED at this time. Regarding the allegation "Facility has ant infestation:" During the virtual initial complaint inspection, LPA interviewed Resident Care Director (RCD) throughout the inspection. RCD indicated "yes, I have seen ants in the facility." RCD is aware of ants in the Directors' Offices, as well as in resident rooms. She has heard from at least 3-4 residents recently who complained of ants. RCD called a pest control company, who came last week to spray the exterior, but RCD indicated everything inside was not treated. RCD provided invoice from the pest control company which does reflect "exterior general pest control" was completed on 08/28/2020. Interview with residents revealed that 5 of 7 residents interviewed have seen ants and indicated there is an ant problem in the facility. Therefore, based on interview, the allegation "facility has ant infestation" is deemed SUBSTANTIATED at this time. Pursuant to Title 22, California Code of Regulations, the following deficiency is cited (refer to LIC 9099-D) Exit interview conducted, appeal rights discussed, and a copy of this report and appeal rights were provided via email. caregivers," "they (caregivers) are nice not rude or disrespectful," and "are all very nice and kind." Staff interview revealed there are some residents who are a "bit feisty" but staff still treat them with dignity and respect. No staff interviewed have ever heard another staff say anything disrespectful to any resident. Based on interviews, although the allegation may be valid, at this time there is insufficient evidence to support the allegation. Therefore, the allegation that "staff not treating resident with dignity" is deemed UNSUBSTANTIATED at this time. Regarding the allegation " Staff not assisting resident with ADLs:" Record review revealed that R1 had a change of condition, which was reflected in a 09/03/2020 care plan. R1 then became a 2-person assist with most ADLs. Care notes indicated staff assisting R1 regularly. Staff interviews revealed staff assist with incontinence needs every 2 hours, or as needed. Residents who are on a 2-person assist, they call on the walkie-talkies for an additional care staff when needed. LPA observed staff attending to residents during facility visits. Resident interviews revealed that care staff do assist with ADLs regularly and residents stated they feel their needs are being met. Although the allegation may be valid, at this time, based on interview, there is insufficient evidence to support the allegation. Therefore the allegation "staff not assisting resident with ADLs is deemed UNSUBSTANTIATED at this time. No citations issued. Exit interview conducted with Executive Director. A copy of the report was provided via email.