Complaint Investigation Report

Allegation: Facility did not report suspected abuse in a timely manner

Based on interviews and record reviews, R1 reported the incident to the ombudsman on 09/13/21. On 09/21/21, LPA C Fowler received a faxed SOC341 report from ED stating that the Ombudsman asked the ED to complete an SOC341 while the ED was still in the process of completing the investigation of the incident. LPA confirmed with ED that facility failed to report the suspected elder abuse in a timely manner. ED also told LPA that unusual incident report (LIC 624) was not completed/sent to CCLD regarding the incident.

Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties .

Exit interview conducted. Appeal Rights and a copy of this report provided.