157203395-12-14-2022-24-AS-SPIY-CMDMEU-20221223083315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157203395
Report Date: 12/14/2022
Date Signed: 12/14/2022 06:06:35 PM

Unsubstantiated

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
09/19/2022 and conducted by Evaluator Darius Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220919084218

FACILITY NAME:	BROOKDALE RIVERWALK		FACILITY NUMBER:	157203395
ADMINISTRATOR:	WEBSTER, REG		FACILITY TYPE:	741
ADDRESS:	350 CALLOWAY DR		TELEPHONE:	(661) 587-0221
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY:	376	CENSUS: 285	DATE:	12/14/2022
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Administrator Reg Webster		TIME COMPLETED:	11:38 AM

ALLEGATION(S):

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Staff inappropriately discarded resident's medication
Staff did not respond to resident's call button in a timely manner
Staff did not administer resident's medication

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Darius Williams conducted a follow up complaint visit. LPA Williams met with Administrator Reg Webster and discussed the purpose of the visit.

In regards to the allegation, staff inappropriately discarded resident's medication, according to Staff 1, Resident 1's medications were never destroyed. LPA reviewed records and it did not show any medications being destroyed.

In regards to the allegation, staff did not respond to resident's call button in a timely manner, LPA Williams attempted to interview Resident 1 (R1) with no success. According to the Reporting Party this incident occurred May 2022. LPA Williams interviewed Staff 2 on 10/31/2022, who reported she did not remember an incident in May 2022.

*Continued on LIC 9099-C*

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Serigy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius Williams	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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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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
09/19/2022 and conducted by Evaluator Darius Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220919084218

FACILITY NAME:	BROOKDALE RIVERWALK		FACILITY NUMBER:	157203395
ADMINISTRATOR:	WEBSTER, REG		FACILITY TYPE:	741
ADDRESS:	350 CALLOWAY DR		TELEPHONE:	(661) 587-0221
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY:	376	CENSUS: 285	DATE:	12/14/2022
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Administrator, Reg Webster		TIME COMPLETED:	11:38 AM

ALLEGATION(S):

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Staff did not provide resident with an air mattress in a timely manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Darius Williams conducted a follow up complaint visit. LPA Williams met with Administrator, Reg Webster and discussed the purpose of the visit.

LPA Williams confirmed with the Reporting Party that the allegation occurred in a Skilled Nursing Facility (SNF), which is a facility Community Care Licensing does not supervise. The California Department of Public Health (CDPH) has oversight over SNF's. On 10/25/2022, LPA Williams forwarded the allegation to CDPH on behalf of the RP.

This agency has investigated the complaint alleging staff did not provide resident with an air mattress in a timely manenr. We have found that the complaint was UNFOUNDED could not have happened, and/or is without a reasonable basis, therefore we have dismissed the complaint.

An exit interview was conducted and a copy of this report will be provided via e-mail.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Serigy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius Williams	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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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Control Number 24-AS-20220919084218

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BROOKDALE RIVERWALK	FACILITY NUMBER: 157203395
	VISIT DATE: 12/14/2022

NARRATIVE

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In regards to the allegation, staff did not administer resident's medication, according to Memorial Hospital Bakersfield medication discharge report dated 9/14/2022, it states for R1 to stop taking Levothyroxine 75mcg and to begin taking the same medication as a 150 mcg dose. According to facility records and interview, the 150 mcg dose was pending fill from the pharmacy and R1's first dose of medication was administered on 9/17/2022.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report will be provided via e-mail.

SUPERVISOR'S NAME: Serigy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius Williams	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC9099 (FAS) - (06/04)

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