Complaint Investigation Report

Medical records, Resident #1’s file review, and interviews conducted indicate that Resident #1 was a fall risk. It is documented that Resident #1 had poor vision, required assistance with walking, and required the use of a walker. Resident #1’s physician report dated 8/27/19 states that resident #1 is unable to leave the facility unassisted. Administrator, Ivonne Meador was aware of this and had Resident #1’s family member, sign a waiver of liability and hold harmless agreement dated 10/19/19, because Resident #1 would take daily unsupervised walks. Administrator did not get approval from Community Care Licensing to use a waiver of liability and hold harmless agreement. Staff interviewed stated they were never told not to let Resident #1 go out alone. The facility failed to follow resident #1’s physician’s report, and allowed resident #1 to leave the facility unassisted.

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.

Immediate Civil Penalty will be issued in the amount of $500.00

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, and copy of report and appeal rights were provided.