Senior Care Records.

Complaint Investigation Report

Vine Ridge Senior Living, Cloverdale10/13/2021Licence 496803825

Census21
Date signed10/14/2021 11:26:49 AM
The inspector’s account

496803825-10-14-2021-21-AS-HDBI-C7ZVJ4-20211021162808

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 101 GOLF COURSE DR. STE. A-230

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

06/28/2021 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20210628131611

Facility staff do not keep the facility clean

Facility is not following their Mitigation Plan

Facility staff are not keeping accurate medication logs

Facility staff are not dispensing medications as prescribed

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on the above captioned complaint allegations. LPA met with Administrator and discussed the department's findings. During the course of this investigation statements were taken from staff; residents; witnesses. In addition, six unannounced site visited were made to the facility and photographs were taken of various areas. Numerous records and documents were obtained and reviewed. The following determinations have been made: Staff reports and site visits made support that the mitigation plan for the facility is being followed; Facility observed to be clean at all unannounced site visits; reviews of Medication Administration Record and other logs as well as statements made by staff and administrator indicate procedures for medication administration and record keeping is in line with Title Twenty-Two regulations. Although the allegations may be true, based upon the records and statements, as well as observations, there is not a preponderance of evidence to support the allegations. Therefore, the allegations are UNSUBSTANTIATED.

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