Complaint Investigation Report

The facility provides Lodging, Food services, Laundry Service, Cleaning of client room, arrange and provide transportation to appointments, a planned activity program, "continuous observation, care and supervision, as required", assistance with bathing and personal needs, as required, assistance with meeting necessary medical and dental needs, assistance with taking prescribed medications, and optional services for a fee.

Per review of the facility schedule, the licensee scheduled one direct care staff per shift. It was observed that anytime there was more than one (1) staff member is when an administrator is on the schedule.

Per review of resident records for R1 and R2. According to the LIC 602 Physician Report, both residents are able to care for all needs, able to leave the facility unassisted, and does not need constant medical supervision. According to R1's appraisal, R1 was not on a 1:1 staffing ratio. According to R2's appraisal, R2 was not on a 1:1 staffing ratio.

Per review of an unusual incident report submitted by the facility, R2 went into R1's bedroom and made physical contact with R1's head. According to R1, the assault was unprovoked. R1 reported the incident to the staff member on shift, which then contacted Galt Police Department, the Administrator, and both resident's case manager. During the incident, staff on shift was completing R1's laundry. Based on staff interviews, R2 has not assaulted a resident in care prior to the incident on 10/05/2024.

Although R2 assaulted R1, records review and staff interviews show that there were staff on shift and there was no indication of neglect or lack of supervision. Staff on shift were completing other household duties for residents in care. Staff was also immediately present after the incident occurred. The facility is required to have one staff on shift, which the requirement was met.

Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, and therefore the allegations are unsubstantiated. Per California Code of Regulations (CCRs) - Title 22, no deficiencies are being cited. An exit interview was held and a copy of report was left.