Complaint Investigation Report

Regarding allegation, “Facility did not seek timely medical attention”, On 5/14/24, staff noted R1 needed medical attention, but R1 refused. Staff felt 911 should have been called anyway. On 5/16/24, 911 was contacted and R1 declined when they arrived. It wasn’t until 5/17/24 where R1 was taken to the hospital for shortness of breath. Based on a review of documentation, and interviews the preponderance of evidence standards has been met.

Due to this information from interviews and medical records review, Community Care Licensing (CCL) finds this allegation(s) to be SUBSTANTIATED - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

You are hereby notified that a civil penalty in the amount of $500.00 is assessed for a violation that resulted in serious bodily injury/serious injury of a client, or that constitutes physical abuse of a client.

The licensee was informed that a civil penalty assessment based on Health and Safety Code 1569.49 is currently under review (pending determination) and may be assessed on a later date, as a result of R1’s sustaining pressure injuries (serious bodily injury) while in care of the facility.

Once civil penalty assessment has been determined, CCL will return on a future date to assess the civil penalty.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, the following deficiencies are being cited on the attached 9099D during this visit. If any of the cited deficiencies are not corrected by the noted due dates; civil penalties may be assessed. The Caregiver was provided a copy of their rights (LIC9058) and their signature on this form acknowledges receipt of these rights.

Exit interview held with Administrator. A copy of todays’ report provided.