157208915-4-25-2023-24-AS-MHON-CRJNBL-20230505101918

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208915
Report Date: 04/14/2023
Date Signed: 04/25/2023 02:28:42 PM

Unfounded

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
01/31/2023 and conducted by Evaluator Lisa Salazar

COMPLAINT CONTROL NUMBER: 24-AS-20230131114452

FACILITY NAME:	PALMS AT SAN LAUREN, THE		FACILITY NUMBER:	157208915
ADMINISTRATOR:	RICE, DOUGLAS		FACILITY TYPE:	740
ADDRESS:	5300 HAGEMAN RD		TELEPHONE:	(661) 218-8333
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93308
CAPACITY:	68	CENSUS: 66	DATE:	04/14/2023
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Doug Rice, Administrator		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Facility staff are not meeting resident's hygiene needs
Facility staff are not meeting resident's dietary needs
Facility staff are not cleaning resident's room and linens
Facility staff do not reposition resident

INVESTIGATION FINDINGS:

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On 04/14/23, Licensing Program Analyst, (LPA) L. Salazar arrived at the facility unannounced to deliver findings on the above allegations. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility.

During the investigation, LPA toured the facility and Resident R1's room, conducted interviews and records review. LPA observed R1's room and bedding to be clean, free from odor, pests, and debris. R1 was observed in a king size bed that has an adjustable base at the bottom. R1 demonstrated on a hand held remote control, how they reposition their bed if needed. LPA's observed R1's hair and nails to be trimmed and clean.

Records review show R1 has been receiving Hospice services and at the end of life. Hospice records show R1 sleeps 18+ hours a day and has a decreasing appetite and eats 25 – 50% of meals per day and often refuses meals. LPA reviewed facility's menus for the month of November and December 2022. LPA observed facility menus to offer two different daily options for entrees, sides and dessert and also an alternative menu if requested.

Based on the information received, we have found that the complaint was Unfounded, meaning that the allegations are false, or are without reasonable basis, therefore, we have dismissed the complaint.

Exit interview conducted with Administrator and a copy of this report was provided at the time of visit. No deficiencies cited.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa Salazar	TELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

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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