Complaint Investigation Report

It was alleged that staff do not treat resident with dignity or respect. It was reported that Resident #1 (R1) is being discriminated against and threatened to be kicked out of the facility. Interviews conducted with staff revealed that certain staff have a tendency to speak condescendingly to residents, which negatively impacts the residents experience. Additionally, there appears to be a pattern of favoritism, with certain residents receiving preferential treatment over others. Interviews conducted with residents reinforced these concerns; several reported that specific staff members address them disrespectfully, particularly when requesting assistance with daily tasks around the facility. Many residents expressed feelings of harassment and being singled out by these staff members. Additionally, residents observed instances where the same staff displayed disrespectful behavior toward other residents. Based on the information obtained and reviewed, the Department has sufficient evidence to say the alleged violation occurred. Therefore, allegation “staff do not treat resident with dignity or respect” is deemed Substantiated at this time.

It was also alleged that staff did not follow admission procedure prior to accepting a resident into care. It was reported that Resident #1 (R1) had not been properly assessed or admitted into the facility. During records reviewed, the LPA did not observe a medical assessment for R1 in the file. Interviews conducted with staff revealed that the admissions protocol is consistent for all residents. A standardized admissions packet is completed for each resident upon admission. Additionally, if a resident is transferred from one facility to another within the same company, a new admissions packet is completed for the resident for the new admitting facility. However, the LPA informed staff that R1’s medical assessment was missing from the file and facility staff was unable to provide a copy of R1’s medical assessment that was dated within the past year at the time of the visit. Based on the information obtained and reviewed, the Department has sufficient evidence to say the alleged violation occurred. Therefore, allegation “staff did not follow admission procedure prior to accepting a resident into care” is deemed Substantiated at this time.

The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of the report and appeal rights were provided.