Health inspection·December 13, 2024

The following reflects the findings of the California Department of Public health during a standard abbreviated survey regarding investigation of a complaint. Event ID: RGZW11 Exit date: 11/13/24 Representing the Department: 2651 State Citation B was issued. F609 §483.12(b) The facility must develop and implement written policies and procedures that: §483.12(b)(5) Ensure reporting of crimes occurring in federally-funded long-term care facilities in accordance with section 1150B of the Act. The policies and procedures must include but are not limited to the following elements. (B) Each covered individual shall report immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, or not later than 24 hours if the events that cause the suspicion do not result in serious bodily injury. On 10/4/24, an unannounced standard abbreviated survey was conducted at the facility, a complaint regarding Resident Abuse was investigated. The facility failed to follow their policy and procedure for Resident 1. This failure had the potential for residents being at risk of abuse/harm. Findings: Resident 1 was admitted with diagnoses which included cerebral vascular disease (a group of conditions that affect blood flow and the blood vessels in the brain), Alzheimer's disease (a brain disorder that gradually destroys memory and thinking skills, and eventually the ability to perform daily tasks), major depressive disorder, anxiety disorder, and a history of falling. During an interview with the director of nursing (DON) on 10/4/24 @ 1:50 p.m., the DON had been notified of an allegation of abuse against licensed vocational nurse A (LVN A), the DON stated they had not had any problems with LVN A. During an interview with the DON on 11/20/24 at 10:42 a.m., the DON stated the allegation of abuse brought to her attention was not reported to the police. The DON further stated if they were notified by anyone other than California Department of Public Health (CDPH) they would have reported it. During a review of the facility's policy and procedure (P&P) titled, Abuse, Neglect, Exploitation, or Misappropriation-Reporting and Investigating, dated 2001. The P&P indicated, ...1. If Resident Abuse, Neglect, Exploitation, misappropriation of resident property, or injury of unknown source is suspected, the suspicion must be reported immediately to the administrator and to other officials according to state law. The facility failed to follow their policy and procedure for Resident 1. This failure had the potential for residents being at risk of abuse/harm. This violation had a direct or immediate relationship to health, safety or security of the patients.