Complaint Investigation Report

On 01/25/2022, between 10:15am and 12:00pm, LPA Walker conducted the initial complaint visit. The LPA met with Administrator Evelina Papazyan at 10:22am and explained the reason for the visit. The LPA conducted a physical plant tour at 10:23am, briefly spoke with staff, conducted a file review and obtained copies of pertinent documentation. The Administrator was notified that the complaint was referred to Community Care Licensing Investigations Branch (IB) and assigned to Investigator Jose Santana.

Investigator Santana conducted interviews with Witness #1 (W1) on 01/26/2022, at approximately 1:15pm; with the Long Term Care Ombudsman (LTCO) Region II Regional Manager on 01/27/2022, at approximately 2:00pm; with Witness #2 (W2) and R1 on 02/01/2022, from approximately 11:45m to 12:10pm; with Witness #3 (W3) on 02/09/2022, at approximately 4:00pm; with Los Angeles Police Department (LAPD) Van Nuys Station on 02/10/2022; with facility Administrator Evelina Papazyan and staff on 02/24/2022, from approximately 10:35am to 12:20pm; with CVHCare Home Health Nurse on 03/02/2022, at approximately 4:30pm; with facility staff on 03/04/2022, from approximately 3:35pm to 4:45pm; with CVHCare Home Health Nurse and Kaiser Permanente Panorama City Nurse Practitioner on 03/09/2022, from approximately 10:00am to 11:55am; with facility staff and Administrator on 03/16/2022, from approximately 1:40pm to 2:30pm; with former staff on 03/17/2022, at approximately 3:00pm; with Kaiser Permanente Case Manager on 03/29/2022; with CVHCare Home Health Nurses on 04/02/2022, from approximately 9:00am to 9:10am; and with R1’s former Primary Care Physician on 04/11/2022, at approximately 5:45pm. Additionally, Investigator Santana obtained and reviewed copies of R1’s facility records, medical records including hospital, Emergency Medical Services (EMS), CVHCare Home Health records, and photos of R1’s pressure injuries.

R1’s Physician Report, dated 02/15/2020, listed the primary diagnosis as knee pain. R1 was listed as non-ambulatory with a history of backside redness and breakdown; did not have impairment of bowel and bladder; needed assistance with bathing and grooming; and was able to store and manage own medications. The Resident Appraisal, dated 03/01/2020, noted R1 as being non-ambulatory; requires the use of a wheelchair; needs assistance with activities of daily living (ADLS); can communicate clearly; is alert and oriented with no signs of confusion; likes watching tv and computer, sits in front of computer all day; and requires assistance with toileting, grooming and transferring.