Facility Evaluation Report

Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with facility administrator Jennell Revera and explained the purpose of the visit.

During the course of a complaint investigation related to the care of a resident (R1), LPA Moleski conducted interviews with Revera, a resident (R1), three responsible parties for R1 (R1’s RPs 1-3) and 11 staff members (S1-S11). See complaint # 27-AS-20240813084041 for more details. This report addresses deficiencies discovered during that investigation.

LPA Moleski reviewed R1’s progress notes from the days preceding R1’s hospitalization on 8/8/24. A note authored by S5 dated 8/1/24 indicated that R1 was tested positive for COVID-19. A note authored by S7 dated 8/2/24 indicated that R1 had a video appointment with their primary care physician. The note further indicated that during this appointment, R1’s physician "asked [R1] to keep [themselves] hydrated and report to staff any changes." Per S7’s note, R1 was “only having a cough, no sore throat and a runny rose [sic]” at the time. S7 also indicated that R1 was prescribed and given Paxlovid to treat R1’s COVID-19.

LPA Moleski reviewed an internal facility incident report, dated 8/8/24, which described R1 suffering from increased confusion. R1’s responsible parties called for emergency medical services, and R1 was taken to the hospital for treatment, according to the internal incident report. The Community Care Licensing Division did not receive an incident report regarding this incident within seven days, as required per 22 CCR 87211(a)(1)(D).

LPA Moleski reviewed medical records related to R1’s hospitalization on 8/8/24. According to R1’s medical records, R1 was diagnosed with lactic acidosis, acute renal insufficiency, hyponatremia, and leukocytosis upon admission to the emergency room. [continued on 809-C]