155801264-7-10-2020-24-AS-AXIG-BRLSQK-20200717140452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 155801264
Report Date: 07/10/2020
Date Signed: 07/10/2020 03:08:00 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2020 and conducted by Evaluator See Moua

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20200513133351

FACILITY NAME:	HALLMARK OF BAKERSFIELD		FACILITY NUMBER:	155801264
ADMINISTRATOR:	MATTHEWS, SAVANNAH		FACILITY TYPE:	740
ADDRESS:	2001 AKERS ROAD		TELEPHONE:	(661) 834-0200
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93309
CAPACITY:	70	CENSUS: 47	DATE:	07/10/2020
		UNANNOUNCED	TIME BEGAN:	02:33 PM
MET WITH:	Savannah Matthews, Administrator		TIME COMPLETED:	02:34 PM

ALLEGATION(S):

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Staff fails to properly care for resident's wound resulting in pressure injury
Staff requested hospice for resident against resident's and family's request
Staff member threatened resident into accepting hospice

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) S. Moua called and spoke with Administrator Savannah Matthews regarding the complaint allegations. Findings were delivered over the phone due to COVID 19 precaution guidelines.

The Department interviewed facility staff, resident, and the resident’s family member. Interviews conducted with family member and the resident confirmed that they were consulted on and agreed to hospice services. Resident denied the facility threatened her into accepting hospice services. Resident also denied the facility failed to properly care for her wound. Records reviewed confirmed that the stage 2 wound was being cared for and treated through Home Health. Based on records reviewed and interviews conducted, the allegations are Unfounded. Exit Interview was conducted.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda White	TELEPHONE: (559) 650-7908
LICENSING EVALUATOR NAME: See Moua	TELEPHONE: (559) 580-6596
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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