Complaint Investigation Report

486803895-6-12-2024-21-AS-KMOA-D6ERNZ-20240620131109

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

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

04/18/2024 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20240418140944

Staff did not provide resident medical attention in a timely manner.

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. During the course of this investigation, statements were taken from witnesses and staff, documents were obtained and reviewed and site visits made to the facility. The following determinations are made: Resident (R1) died at the facility on 03/25/2024 of cardiopulmonary arrest; R1 was elderly and suffered numerous serious medical conditions; Records indicate that staff on duty 03/25/2024 had received required training and responded appropriately when R1 became non responsive; Available records suggest that the staff provided a timely response when R1 became non responsive and that they took appropriate action by initiating CPR and calling 911; R1's Conservator has stated that Conservator believes the staff have taken good care of R1 and that the staff took timely action in response to R1's medical episode. Although the allegation may be true, based on records and statements, there is not a preponderance of evidence to prove, or disprove, the allegation. Therefore, the allegation is UNSUBSTANTIATED.