Complaint Investigation Report

Staff interview revealed that residents were checked for common Covid-19 symptoms and a Med Tech or LVN would decide if a Covid-19 test should be administered. Staff interview revealed that Covid-19 tests would not typically be administered to residents with uncommon Covid-19 symptoms.

Outside source records review showed that staff declined to test a resident per family request because the resident was not showing 3 Covid-19 symptoms. Additionally, records showed that staff stated this was a public health rule. Outside source interview revealed that San Diego County Public Health did not have a "3-symptom" requirement for a resident or staff to be tested for Covid-19. Review of the facility's internal infection control document showed that the facility did not specify a minimum number of required symptoms in order for a resident or staff to be tested for Covid-19. Review of the facility's Mitigation plan called for testing upon symptoms and did not specify a minimum number of symptoms before a resident could be tested.

Outside source interviews corroborated that staff refused to test R1 and R2 for Covid-19, upon request, because they did not present with 3 symptoms. Interview revealed that staff stated the 3-symptom rule was a State requirement. Both residents in question were tested privately and/or 48 hours after request, and tested positive for Covid-19. Review of CCLD infection control guidelines related to Covid-19 did not show any protocol where 3 symptoms were required in order to test. Both interviews and record review support the allegation that the Licensee did not follow Covid-19 response requirements by refusing to test residents who did not present 3 Covid-19 related symptoms.

Regarding the second allegation, "Licensee did not assist resident(s) with accessing medical care", it was alleged that the Licensee's refusal to test residents for Covid-19 resulted in the delay of resident(s) receiving medical care. Outside source interview corroborated that staff's refusal to administer Covid-19 tests resulted in R1 and R2 being delayed in seeing their doctors for evaluation and time-sensitive treatment.

Based on interviews and records review, the preponderance of evidence has been met, and both allegations are therefore substantiated. Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC9099-D). A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with Jason McDonald, Executive Director, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.