Senior Care Records.

Complaint Investigation Report

Meridian Manor IV, San Jose02/10/2024Licence 435202651

Census3
Date signed02/10/2024 02:30:07 PM
The inspector’s account

LPA met and interviewed Staff (S1) regarding the incident between him/her and S2. S1 confirmed that the altercation occur on September 16, 2023 at around 4PM-5PM. S1 stated that S2 met someone (in social Media) wherein S2 has been spending a log of time chatting/talking instead of focusing on his/her work. S1 confronted S2 about his/her spending time chatting/talking resulted in verbal and physical altercation.

LPA did not interview S2. S2 is no longer employed at this facility as of November 15, 2023.

Based on available information gathered, S1 heard S2 on the phone with someone. S1 heard his/her name being mentioned by S1 about inappropriate comment about S1. S1 confronted S2 resulted in verbal and physical altercation inside the facility family room area.

Based on investigation, the ADM and/or staff designee did not submit an incident report regarding S1 and S2's physical and verbal altercation in September 2023. LPA Chang is the assigned caseload LPA for this facility and confirmed not receiving LIC624. (Unusual incident Report.)

On February 10, 2024, LPA interviewed ADM. ADM stated he did not send an incident report regarding S1 and S2's altercation on September 16, 2023. ADM stated he did not send the incident report because the altercation did not involve residents. ADM stated the staff cannot fight, and "that's prohibited and against company policy." ADM stated if staff have a grievance, then staff can come to him to resolve it.

Based on interview and record review, the above two allegations that the facility staff had an altercation in the facility that violates residents' personal rights, and the facility did not submit a written report within 7 days. Therefore, the Department found the above allegations to be SUBSTANTIATED.

Deficiencies are being cited. See LIC 9099-D. Exit interview conducted with Administrator Emmanuel G Fernando. ADM stated Staff S1 could sign on her behalf and a signed copy of this report was provided along with appeal rights.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction