Complaint Investigation Report
It was alleged that staff are restraining resident#1-#2(R1-R2) physically or by removing the wheelchair to prevent them from being disruptive and residents are being chemically restrained with over-the-counter (PRN) medications. LPA record review today revealed a physician's order for a wheelchair for R1 and R2. LPA interview with staff revealed they never restrain residents, and R1/R2 were free to roam around the facility. Interview with residents revealed that they are not restrained and residents are assisted immediately when requested. R1 was not interviewed as they are no longer in the facility. During the physical plant tour of the facility conducted on 5.13.2026, LPA did not observe any residents being restrained chemically or physically and were happy roaming freely around the facility. Medications were stored centrally stored and medication review did not reveal PRN for restraining purposes.
Based on interviews, observation, and record reviews, there is no sufficient information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.
Allegation: Staff do not treat residents with dignity and respect.
Regarding the above allegation, it is alleged that the facility staff slammed a resident into the bed and held the resident there. Interviews with residents revealed that they are happy with the care provided and have not experienced such treatment from staff. R1 was not interviews as they are no longer at the facility. Interviews with staff revealed that they treat all their residents with dignity and respect. Upon review of facility records, there was no information to support the allegation. LPA reviewed last personal rights training given to staff on 2.3.2026.
Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.
Allegation: Staff mismanage residents medication.
It was alleged that facility staff mismanage residents' medication by missing dosages and not giving the residents their medication in a timely manner. To investigate this investigation, LPA reviewed the Centrally Store Medication and Destruction Record (CSMDR) and Medication Administration Record (MAR) for 6 residents and did not observed discrepancies. Continue to LIC 9099-C
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction