Complaint Investigation Report

facility, interviewed Residents (R1-R6), interviewed Staff (S6-S9), and received documents pertinent to the investigation. The documents reviewed and received include Staff Roster, Resident Roster for Memory Care Unit, Staff Training Logs of 100 modules Dementia Care and 10 modules on Falls, Resident Admission Agreement, Physician Reports, Communication Logs, and Safeguard of Property.

During an additional subsequent visit conducted on 08/29/24, LPA met with Assistant Executive Director/Memory Care Director, Cecille Bernabe and Office Business Manager, Raul Pereira. During the visit, LPA toured the facility, interviewed Staff S2, and received documents pertinent to the investigation. The documents received and reviewed include Unusual Incident/ Injury Reports (SIR)s, Outside Agency Documentation, Skin Integrity Monitoring Form, Internal Occurrence report, and resident Hospital Discharge paperwork.

The investigation revealed the following:

Allegation: Staff did not safeguard resident’s personal items

The complaint allegation alleges resident’s personal items such as clothes and tooth brush have gone missing.

During the facility record review, LPA received and reviewed a copy of the Client/Resident Personal Property and Valuables (LIC621) for sis residents. LPA observed six (6) out of six (6) residents declined to fill out the form. During review of residents Admission Agreement, LPA observed in Appendix K Safeguard of Resident Property on page 2 states “the facility shall not be liable for items which have not been requested to be included in the inventory or for items which have