Complaint Investigation Report

306001000-3-1-2023-22-AS-AORZ-CPKQPT-20230303112117

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 770 THE CITY DR., SUITE 7100

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

02/14/2023 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20230214144423

Lack of staffing resulted in facility not meeting resident's needs.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegation. LPA was greeted and granted entry into the facility by Executive Director (ED) Melissa Weibel and explained the reason for the visit. Wellness Director Michelle Drinkard arrived during the visit.

During the course of the investigation, LPA toured the facility, interviewed staff and residents as well as reviewed and obtained pertinent documentation such as physician report and staff achedule. Regarding the allegation that lack of staffing resulted in facility not meeting resident's needs, the investigation revealed the following: Four out of four staff and six out of six residents confirm staffing issues during the time frame alleged in complaint. Four out of four staff indicate Resident 1 (R1) was a 2 person assist and sometimes there would be only one caregiver working. All staff interviewed state staffing issues are improved as of time of complaint filing. Facility does not provide the pendant response log to the department. 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, Chapter 8), are being cited on the attached LIC 9099D. An exit interview was conducted with ED and a copy of this report was provided as well as appeal rights.