Complaint Investigation Report

Per Physician Report from Sunrise Assisted Living Santa Monica dated 8/3/2021 R1 has dementia is confused/ disoriented, has sundowning behavior, and is not able to leave facility unassisted. R1 is not able to store own medication. Per Primary Care Physician (PCP) letter written 3/16/2020 “due to chronic condition, both physical and cognitive, R1 needs ongoing assistance from caregivers to help with activities of daily living which is essential to residents’ safety. On 12/24/21 R1 was moved to Atria Park of Pacific Palisades; Per Physician Report from Atria Park of Pacific Palisades dated 2/24/22 R1 is diagnosed with Dementia: Capacity for self-care ; not able to : bathe self, dress groom/self, able to care for own toileting needs.

Per Unusual Incident Report (UIR): On 11/28/2021 at approximately 1PM R1 attempting to leave the community and was observed rubbing genital area and complaining of pain. R1 was redirected, and family was notified. Staff have also reported redness/ skin breakdown in in residents’ genitals while providing care.

- Regarding allegation Facility staff sexually assaulted resident : On 11/30/21 LPA Cardenas interviewed Reporting RP who indicates that a Sunrise caregiver inspected R1s genitals by force and reported that genital area was red, swollen, and had lesions. R1 would not consent to a genital inspection, R1 is self reliable and capable of caring for own personal hygiene needs. R1 has not complained about sexual abuse, nor mentioned any genital discomfort. LPA was not given consent from family to interview R1 due to resident is nocturnal and doesn’t not like being disturbed. On 12/07/21 LPA received an email from RP withdrawing complaint against facility. RP mentioned that facility must have lied as an excuse to move R1 from assisted living unit into memory care and increase payment rate. On 12/06/2021 LPA Cardenas interviewed S2 who indicates that on 11/28/21 R1 was attempting to leave facility. S2 noticed R1 was wearing a soiled gown and scratching lower-body part including genitals. During a recent stand up meeting S3 told her that R1 was facing bedroom door and was observed with button down gown wide opened. Staff observed from afar that there was skin breakdown and what appeared to be a rash in the genital area, no physical contact was made. On 12/13/2021 LPA interviewed S3 who does not recall observing or reporting such incident, S3 denies conducting any genital inspection body check on R1. S2-S7 indicated that none of the residents have reported sexual abuse, nor witnessing any sexual abuse. S4 indicates family is restricting staff from doing their job and rendering care. Last month R1 had dry scaly skin and kept scratching all over the body. Staff don’t have consent to apply lotion because staff are not allowed to touch resident. On 12/06/2021 LPA interviewed R2-R8 who indicate that they feel safe at the facility. R2-R8 have