Complaint Investigation Report

of the kitchen, food supply, observation of facility elevator and a random selection of resident rooms. LPA measured the water temperature in the resident rooms. LPA additionally reviewed R1’s facility file and collected copies of documents pertinent to the investigation and conducted a phone call to Silverado Hospice.

Investigation revealed the following: Regarding allegation, Facility staff does not ensure that residents have hot water , it is alleged that the facility does not have hot water as of 01/11/23 and resident(s) only received a sponge bath as there was no hot water in the building. Facility also allegedly did not notify resident’s family or responsible parties of the issue with the water. It is also alleged that resident(s) are retaliated against if they speak up when things are not right in the facility. Interviews conducted with facility administrator and staff revealed that the facility does have hot water at all times. Administrator stated that water is checked weekly to ensure that the water is always set at the required temperature that is between 105 F - 120F and stated that family members and responsible parties are notified of any important issues or problems, if any, when they arise. Staff interviewed denied that residents are retaliated against if they bring up any concerns. Interviews conducted with 5 out of 5 residents revealed that the facility always has hot water. 1 out of 5 residents stated that when it is cold the water takes longer to heat up and it might be due to where their room is located which is in the rear of the facility. 5 out of 5 residents denied that staff retaliate against residents if they bring up any concerns. On 01/19/23 and 11/27/23, LPA measured the water temperature in a total of six (6) resident bathrooms and the reading for all bathrooms ranged between 110F - 115F which is between Title 22 regulation requirement. Based on interviews conducted with facility staff, facility residents, and LPA observations, there was not enough supportive evidence to concur with the reported allegation.

For allegation, Facility is in disrepair, it is alleged that there is no alarm in the rear exit of the facility and there should be one as the facility provides services to residents with dementia, and the facility does not have a working elevator for the residents that live upstairs. Interviews conducted with Administrator Harvey and Assistant Administrator Claudia Sanchez revealed that the facility has 1 nonoperational elevator. They stated that the facility was licensed like that, and the facility was cleared by the Monrovia City Fire Department as well as Department of Industrial Relations (DIR). LPA Gonzalez reviewed approved STD 850 Facility Fire Inspection Request which was approved on 08/25/22 and indicates that all nonambulatory residents are to reside on the 1 st floor and all ambulatory residents are to reside on the 2 nd floor. This information is reflected on the facility license. On 11/10/22, LPA Katrdzhyan spoke to DIR Senior Inspector who informed LPA Katrdzhyan that DIR does not require the building to have an operable elevator. Senior Inspector also stated