Complaint Investigation Report

216803747-7-12-2022-21-AS-KMOA-CGBLU7-20220714090326

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

06/15/2022 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20220615145525

Staff left resident in care in soiled undergarments for extended periods of time

Staff failed to inform physician of resident's change in condition

Staff failed to inform responsible parties of change in condition

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on the above captioned complaint allegations. LPA met with Adam Waskow and discussed the findings. During the course of this investigation, the Department interviewed staff and other witnesses, reviewed photographs, obtained documents, and made site visits to the facility. The following determinations are made: Complainant alleges facility staff did not report R1's change in condition and did not provide adequate hygiene care for R1; Personal physician for R1 states physician was notified of changes and that care of residents at the facility is excellent; Hospice nurse states facility staff have provided good care for R1; This Department has found no evidence of that staff did not make necessary reports or left R1 in soiled condition; No care notes for the month of April 2022 have been provided by facility for review and staff claim an extensive search for the notes has been made. Administrator states allegations are unfounded and states an appeal will be made. Although the allegations may be valid, or true, based upon the statements made and lack of critical documents, there is not a preponderance of evidence to prove the allegations did, or did not, occur. Therefore, the allegations are UNSUBSTANTIATED. Report left at facilty. No citations issued.