Complaint Investigation Report

Review of records confirmed the licensee and administrator's statements; however, Admission Agreement indicated that facility is to provide assistance with obtaining a doctor and medical services as needed. Administrator and staff (S1) confirmed that R1 does not need assistance with activities of daily living (ADLs) such as bathing, feeding, dressing, toileting and feeding consistent with R1's LIC602 Physician's Report.

2. R1 has been exhibiting challenging behaviors manifested by mis-communication, mis-perception, over-reaction and/or magnification of an incident

This reason for eviction does constitute ground for eviction.

Administrator stated that R1's family member has been informing her that they (staff) need to repeat and ask R1 number of times due to R1 may seem to understand but may actually not. R1's Quarterly Review dated February 9, 2021 listed behavior of yelling with frustration indicated as antecedent condition when R1 is not able to communicate well. LPA interviewed the administrator and S1 who both indicated R1 does not have aggressive nor self-injurious behavior. Administrator indicated R1 only had yelling episode twice when R1 moved-in consistent with Quarterly Review. Facility does not have documentation nor have Behavior Tracking Log to support R1 is exhibiting behaviors.

Based on information obtained, the preponderance of evidence is met, therefore the allegation is substantiated. The facility issued 30-day eviction for R1 with reasons that do not constitute grounds for eviction.

Deficiency is cited from Title 22 California Code of Regulations (see 9099D). Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty.

Deficiency and plan and proof of correction were discussed with licensee and administrator,

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy this report provided.