Complaint Investigation Report

286800667-9-9-2021-21-AS-BMOS-C6QNJK-20210910103028

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 101 GOLF COURSE DR. STE. A-230

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

07/08/2021 and conducted by Evaluator Marisol Cuadra

COMPLAINT CONTROL NUMBER: 21-AS-20210708133830

Facility staff physical abused resident in care

The Department conducted a complaint investigation regarding the allegation that facility staff physically abused a resident in care. Licensing Program Analyst (LPA) Cuadra arrived unannounced for the purpose of delivering findings of the investigation and met with Administrator, Laura Sherwood.

It was reported a staff (S1) pushed R1 resulting in R1 falling, S1 proceeded to kick and hit R1 with a shoe. Based on documentation dated 8/25/2021 staff admitted to pushing R1 from behind as well as kicking and hitting R1 with a shoe. Video evidence from 7/04/2021 revealed S1 grabbing and pushing R1 towards the laundry room at which point R1 falls to the ground. Video evidence also shows two staff (S1 & S2) grabbing R1 by the arm and shirt and dragging R1 in the direction of R1’s bedroom. Review of additional video surveillance revealed a second incident on 6/29/2021 involving S1 pulling R1 away from the dining room table, resulting in R1 falling. The Department obtained photo evidence of multiple bruises on R1s body. Based on observations, interviews and a review of records, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. An immediate civil penalty in the amount of $500 assessed due to a violation resulting in injury of R1. The licensee was informed that additional civil penalties are under review by the Department per Health and Safety Code 1569.49 (f).