Complaint Investigation Report

415600980-11-22-2021-14-AS-KHOS-C9JN2X-20211209090528

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 851 TRAEGER AVE., SUITE 360

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

10/19/2021 and conducted by Evaluator Murial Han

COMPLAINT CONTROL NUMBER: 14-AS-20211019114209

Facility is not meeting resident's dietary needs

On 11/22/2021, Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to deliver the findings of complaint # 14-AS-2021101911429. LPA Han was properly screen at the front entrance. LPA Han met with the Resident Service DIrector, Angel Bustos and explained the purpose of the visit.

Regarding to allegation of facility is not meeting resident's dietary needs, according to the hospital's record, it did not indicate that Resident #1 (R1) required a special diet upon returned to the facility, however, according to the facility staff, the Reporting Party requested R1's food to be cut and this request was incorporated in the Resident Functional Needs Assessment after the hospitalization. To ensure this request was followed, the facility staff stated that R1's meals were pre-cut from the kitchen then served. The Reporting Party provided a photo of a meal showing a piece of meat on the plate that was not pre-cut prior to serving, however, there was no indication on the photo illustrating that it was taken after this request was made. In addition, there was no information forthcoming from R1's private caregiver who the Reporting Party stated that witnessed the pre-cut meat.

Base on record review and interviews during the course of investigation, this allegation is unsubstantiated.

Although the above allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted with the Resident Service Director. A copy is provided.