Complaint Investigation Report

It was alleged that staff did not provide a call assistance button or pendant to Resident #1 (R1). LPA C. Yee conducted interviews on 11/21/2023 and four (4) out of four (4) parties interviewed stated that R1 did not have a pendant for a time ranging between one (1) to two (2) days to three (3) weeks. On 10/26/2023, R1 was transferred from assisted living where majority of residents are provided call pendants, to memory care where majority of residents are not provided call pendants. R1 does not have dementia but was transferred to memory care with family’s consent because R1 had increased care needs. The memory care unit consists of twenty-eight (28) rooms, which allows memory care staff to check the residents in the memory care unit more frequently and provide higher levels of care. Per interviews conducted on 12/26/2024, residents in memory care are provided with pendants if their assessment determines that they are able to properly use one. R1’s mental capability of using the pendant did not change when moved to memory care as R1 did not have a change of mental condition. R1 was provided with a pendant after request. R1 was moved back to assisted living on 04/14/2024 after R1’s condition improved. LPA Barutyan observed a pendant with R1 on 12/26/2024. Based on interviews and record review, the allegation “staff did not provide a call assistance button or pendant to resident” is deemed SUBSTANTIATED at this time. R1 and responsible parties of R1 did not have current concerns about pendant usage or call assistance buttons as R1 is now provided with a pendant.

The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiency may result in civil penalties.

Exit interview conducted. Appeal rights and a copy of the report was provided.