Complaint Investigation Report

157208940-9-9-2021-24-AS-MHON-C6XM2R-20210917091354

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

12/28/2020 and conducted by Evaluator Lisa Salazar

COMPLAINT CONTROL NUMBER: 24-AS-20201228090245

Facility did not seek appropriate emergency medical care for resident.

Facility did not coordinate care with home health services agency.

On 07/22/2021, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to deliver findings on the above allegation.

During the course of the investigation, LPA conducted interviews with staff and reporting party. LPA requested documentation from Executive Director evidencing the effort to seek emergency medical treatment due to a change of condition for R1. The facility was unable to provide. LPA conducted review of medical records from hospital and Emergency Medication Services. Records revealed Urgent Care and family of R1 initiated emergency services required.

The Department investigated the above allegations. Based on interviews and records review, the preponderance of evidence standard has been met, therefore the allegations above are found to be SUBSTANTIATED.

Deficiencies are being cited in accordance to California Code of Regulations, Title 22, Division 6, see LIC 9099D. Exit interview conducted and appeal rights given.