Senior Care Records.

Complaint Investigation Report

Kern Village Assisted Living for Seniors, Kernville08/02/2024Licence 157209373

Date signed08/02/2024 02:54:04 PM
The inspector’s account

157209373-8-2-2024-24-AS-SMOA-D7XL29-20240808082159

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

12/28/2023 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20231228152212

Licensee Anthony Barbato, Licensee Legal Representative Iustina Mignea, and Kala Gibson

Staff did not monitor resident's glucose level resulting in death

The Department conducted interviews, reviewed records, and toured the facility. Based on the interviews conducted and records reviewed, the above allegation is Substantiated. Facility staff did not ensure R2 received his medications to treat his insulin-dependent diabetes condition and did not monitor the resident’s glucose level, which resulted in the resident’s hospitalization and death. Citation for care and supervision are issued on the attached 9099-D.

The issuance of additional civil penalties is pending and currently under review. The details of additional civil penalties will be outlined in a future report to the facility, if any.

Exit Interview was conducted and Appeal Rights were provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction