Complaint Investigation Report

Direct Care Orientation Checklist (dated: 12/01/19), Medication Administration Staff Training (dated: 12/01/19), Register of Facility Residents LIC 9020 (dated: 08/24//22 & 04/29/24) and Personnel Report LIC 500 (dated: 08/26/22).

Allegation #2: Facility staff are not monitoring changes in resident's condition.

The details of this complaint alleged that facility staff are not monitoring changes in resident’s condition. It was reported that facility did not provide a skilled nurse to monitor resident #1 (R1) for change in condition. Although, (R1) did not have any change in condition during (R1’s) stay at this facility, it was expected from the facility to provide a skilled nurse to monitor (R1). It was reported that (R1) had visits from a physical therapist to assist with a fracture ankle. A review of resident #1 (R1’s) Identification and Emergency Information LIC 601 (dated: 07/13/22) and Admissions Agreement LIC 604 (dated: 07/13/22), revealed (R1) was admitted to Amor Vida Care on 07/13/23 and voluntarily terminated residency on 08/23/22. On 8/29/2022, between 09:00 am – 5:00 pm, (LPA) Montoya interviewed (3) out (3) staff #1-#3 (S1-S3) denied that facility staff are not following residents’ care plans. (S1-S3) revealed that the on-duty care staff check on (R1) in (R1’s) bedroom at least at least every two hours or as needed. On 8/29/2022, between 09:00 am – 5:00 pm, (LPA) Montoya interviewed (1) out (5) resident #2-#5 (R2-R5). (R2) revealed during the interview that staff checks (R2) blood pressure several times daily and that staff also monitors (R2's) sugar level, oxygen, Covid-19 screening, and temperature daily. (R2) reported that staff frequently checks on (R2). (R3-R5) were not available for an interview and unable to obtain statement from the three residents.

On 04/30/24, between 04:00 am – 5:00 pm, (LPA) Ernand Dabuet attempted to interview resident #3-#5 (R3-R5). A health condition limits (R3-R5’s) ability to carry a full conversation or make a full statement.

(LPAs) Montoya and Dabuet attempted to interview resident #1 (R1) on 08/29/22 and 04/30/24, who no longer resided at the facility. (R1) did not provide a forwarding contact information and unable to obtain a full statement. A review of (R1’s) facility progress notes (dated: 08/3/22 through 08/23/22) and Daily Vital Sign Record (dated: 07/13/22 through 08/22/22), (R1) was being monitored for change in condition.

Allegation #6: Facility staff are not maintaining proper records for residents.

It alleged that facility staff are not maintaining proper records for residents. It was communicated the facility does not maintain records for (R1).

On 8/29/2022, between 09:00 am – 5:00 pm, (LPA) Montoya requested to obtained and review (R1) services records which included the following: Admission Agreement LIC 604 (dated: 07/13/22) Appraisal/Needs and Services Plan LIC 625 (dated: 08/02/22), Physician's Report LIC 602A (dated: 08/02/22), Identification and Emergency Information LIC 601 (dated: 07/13/22), Daily Vital Signs Chart (dated: 07/13/22 – 08/22/23), Progress Notes (dated: 08/03/22 – 08/23/23), Providence Little Company of Mary (dated: 06/12/22 – 07/13/22, and Medication Administration Records, Covid-19 test, Covid Vaccination records, and Covid-19 daily screening.

Allegation #7: Facility staff are asleep on the job at the facility.

It is alleged Facility staff are asleep on the job at the facility. It was reported that facility staff are not sleeping on the job,