Complaint Investigation Report

216804022-6-1-2023-21-AS-HDBI-CSQNPS-20230612103849

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

03/17/2023 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20230317123457

Staff did not safeguard resident's personal belongings

Staff did not meet resident's incontinence needs

Staff did not properly supervise resident

Staff did not assist resident with showering

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. LPA met with Marketing Director and discussed the allegations. During the course of this investigation, this Department has interviewed witnesses and staff, reviewed and obtained documents, and made site visits to the facility. The following determinations are made: Personal belongings of R1, including glasses and hearing aides, were lost, stolen or misplaced while R1 was in care; Although the Licensee did not follow the required investigative and documentation requirements, it remains unknown how the belongings were removed from R1's possession; Statements made by current and former staff, as well as care note entries for R1, illustrate that when R1's spouse was not present at the facility, R1 often refused bathing and changing attempts by staff and could become agitated and aggressive; Facility care notes are kept for 30 days and not all notes were available for review. Although the allegations may be true, based on the statements and documents reviewed, there is not a preponderance of evidence to prove the allegations are or, are not, valid. Therefore, the allegations are UNSUBSTANTIATED.