Complaint Investigation Report

***LPA Kruz Long amended the original report and redelivered complaint report to the facility. Upon arrival LPA met with Rachelle Jacob (Caregiver) and explained the purpose of the visit.***

Regarding allegation: Facility did not obtain medical care for the resident in a timely manner. The allegation, resident #1 fell in the facility and resident #1 sustained injury to head in the form of bruises and bumps and staff returned resident #1 to bed and did not seek timely medical attention for resident #1. Interviews with 3 of 3 staff revealed that the Administrator and staff were aware resident #1 had an unwitnessed fall in the facility on 01/25/22 and sustained a laceration to residents’ cheek and a bruise on the forehead. Administrator reported that resident #1 was not taken to the hospital due to resident #1 family member did not want resident #1 to be taken to the hospital and resident #1 injuries were not life threatening. Staff assisted resident #1 by applying antibiotic cream and ice to the bruises, however, staff did not seek medical attention for resident #1 injuries. Interview with 3 of 4 residents revealed that staff assist resident as needed and residents deny any injuries and do not have any concerns regarding the staff. Resident #1 Family Member #1 reported staff called resident #1 family member on the morning of the incident to notify resident #1 family member of the fall and injury, however, the staff did not report the severity of the injury to family member #1. Several hours later, family member #1 visited the facility and observed resident #1 injury to be more severe that staff reported earlier that day. Interviews with witness #2 revealed that resident #1 fell in the facility and sustained a laceration and bruises on resident #1 face and facility staff did not seek timely medical attention for resident #1. Resident#1 was interviewed by IB investigator Zertuche and denied falling in the facility and reported being hit by a staff, however, resident could not provide any further details regarding the staff and/or incident.

Based upon the information obtained during the complaint investigation, the investigation revealed resident #1 had an unwitnessed fall on 01/25/22 and sustained injuries to resident #1 head: a laceration to resident face/eye area and bruises to resident #1 forehead. Facility staff were aware of resident #1 injuries and notified resident #1 family member around 9:30AM on the day of the injury, resident #1 family member visit the facility a few hours later and observed resident#1 injuries to be more severe that reported by staff, therefore, staff has knowledge of resident #1 injury on 01/25/22 and failed to seek timely medical attention for resident #1 injuries. Based on the department’s investigation, interviews with staff and residents and review of resident#1 file, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Exit interview conducted with Rita Regis (Caregiver) and a copy of this report and appeal rights provided.

During visit, immediate Civil Penalties were issued to licensee in the amount of $500.00.