Complaint Investigation Report

Review of resident #1's file, including needs and services plan dated 6/19/20, indicates that resident #1 had severe cognitive impairment, and a history of wandering throughout the facility. Per documentation and interviews, Resident #1 was often disoriented and confused, and required assistance with completing all activities of daily living.

Staff interviewed stated that resident #1 needed a higher level of care, and/or one to one supervision.

Based on LPA's interviews and records reviewed, the preponderance of evidence standard has been met, therefore the allegation is found SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 8 are being cited on the attached LIC 9099D.

An immediate $500 civil penalty was previously issued.

The licensee was informed that a civil penalty might be assessed based on health and safety code 1569.49 (e)or (f).

Exit interview conducted. Appeal rights explained.