Complaint Investigation Report

547200844-7-30-2024-24-AS-SMOA-D93SMB-20240913135941

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

04/02/2024 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20240402101858

Administrator Katrina Sinift and Regional Director Gary Allinger

Resident sustained injuries due to lack of staff care and supervision.

Facility is not adhering to resident's Admission Agreement.

On this date, Licensing Program Analyst (LPA) K. Kaur, Licensing Program Manager (LPM) S. Moua, and Regional Manager (RM) B. White met with Katrina Sinift, Administrator and Gary Allinger Regional Director. The above allegations were discussed and findings were delivered.

The Department conducted interviews and reviewed records. Based on the interviews conducted and records reviewed, the resident sustained multiple fractures after staff failed to abide by R1’s care plan and the resident fell. Based on interviews conducted, staff admitted to failing to abide by R1’s care plan and continues to conduct one-person assist. The preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

The issuance of additional civil penalties is pending and currently under review. The details of additional civil penalties will be outlined in a future report to the facility, if any.

Citations are issued per Title 22 on the attached LIC 9099D. Appeal rights were given and exit interview was conducted.