Complaint Investigation Report

415601039-9-22-2022-14-AS-KHOS-CQCP8R-20230328110557

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SF COASTAL AC/SC , 851 TRAEGER AVE., SUITE 360

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

06/02/2022 and conducted by Evaluator Audrey Jeung

COMPLAINT CONTROL NUMBER: 14-AS-20220602131917

- Resident’s needs are not being met while in care

- Staff did not ensure that resident is being fed

LPA Jeung observed room where client #1 resides, interviewed client, and discussed current service plan with business office manager and resident services director.

Based upon review of client's file, observation of client's room, interviews with client, staff, and witnesses, this allegation is determined to be unsubstantiated.

In November 2021, client #1 was assessed by facility as independent. Staff were not providing any assistance with ADLs. When client had COVID infection in June 2022, client was unable to care for herself and needed assistance from staff, which was provided, per resident services director. Staff also assisted client with showers, even though this was not stated in client's unsigned service plan. Client had poor appetite and food that staff delivered was not eaten.

Although the allegation may have occurred or is valid, there is not enough evidence to prove the alleged violation did or did not occur.