Complaint Investigation Report

079200962-8-8-2024-15-AS-KHOS-D97NA4-20240917101656

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

03/27/2024 and conducted by Evaluator Alona Gomez

COMPLAINT CONTROL NUMBER: 15-AS-20240327085953

Staff did not provide medical attention to resident.

On 8/8/2024 at 11:50 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct a complaint visit and deliver findings. LPA explained the purpose of the visit to Executive Director, Kiel Stromgren.

During the course of the investigation through document review and interview LPA was unable to determine if R1 received the proper medical attention. LPA interviewed 6 staff members. LPA was unable to obtain a injury assesment form for R1. R1 was unable to be interviewed due to dementia and a language barrier. S6 states that they did a quick assessment of R1 and spent more time assessing R2. According to interviews R1 did not receive a thorough assesment. The facility only noticed the injuries once the responsible party pointed them out.

Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D.