157209192-9-11-2024-24-AS-SPIY-D9EME4-20240924093208

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157209192
Report Date: 09/11/2024
Date Signed: 09/11/2024 01:19:19 PM

Substantiated

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
05/10/2024 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20240510143647

FACILITY NAME:	BRIGHTON MANOR		FACILITY NUMBER:	157209192
ADMINISTRATOR:	KAUR, LAKHWINDER		FACILITY TYPE:	740
ADDRESS:	305 ALUM BAY COURT		TELEPHONE:	(661) 589-1500
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY:	6	CENSUS: 2	DATE:	09/11/2024
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Gina Sadaro		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
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5
6
7
8
9

Facility staff do not properly supervise residents after dispensing their medications

INVESTIGATION FINDINGS:

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2
3
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5
6
7
8
9
10
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12
13

On 9/11/24, Licensing Program Analyst (LPA) M. Medina conducted a subsequent unannounced complaint visit to deliver findings. LPA introduced self, stated purpose of visit, and allowed entrance by staff. Staff, Gina Sadaro contacted by telephone and arrived a short time later to conduct visit.

This department investigated the above allegation, during the investigation, LPA toured facility, conducted interviews, and reviewed records.

Based on observation during facility tour, LPA observed Staff 3 (S3) dispensed medication into cups and had them placed in front of residents as they were seated at the dining room table and walked away, The preponderance of evidence standard has been met, therefore the allegation: facility staff do not properly supervise residents after dispensing their medication is found to be SUBSTANTIATED.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D.

Exit interview was conducted and a plan of correction developed and reviewed. A copy of this report provided to Administrator for facility records.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda Medina	TELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

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

LIC9099 (FAS) - (06/04)

Page: 1 of 3

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
05/10/2024 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20240510143647

FACILITY NAME:	BRIGHTON MANOR		FACILITY NUMBER:	157209192
ADMINISTRATOR:	KAUR, LAKHWINDER		FACILITY TYPE:	740
ADDRESS:	305 ALUM BAY COURT		TELEPHONE:	(661) 589-1500
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY:	6	CENSUS: 2	DATE:	09/11/2024
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Gina Sadaro		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not report unexplained bruising to residents POA
Facility staff do not meet residents' incontinence care needs
Facility staff do not provide enough food to residents during meals

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 9/11/24, Licensing Program Analyst (LPA) M. Medina conducted a subsequent unannounced complaint visit to deliver findings. LPA introduced self, stated purpose of visit, and allowed entrance by staff. Staff, Gina Sadaro contacted by telephone and arrived a short time later to conduct visit.

This department investigated the above allegations, during the investigation, LPA toured facility, conducted interviews, and reviewed records.During course of the investigation, LPA toured facility, reviewed records, and conducted interviews. This department had insufficient information regarding the allegations listed above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred therefore the allegations are UNSUBSTANTIATED.

No deficiencies issued during this complaint visit . Exit interview conducted. A copy of this report was provided to Administrator for facility records

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda Medina	TELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

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

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 24-AS-20240510143647

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: BRIGHTON MANOR	FACILITY NUMBER: 157209192
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/11/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/25/2024 Section Cited CCR 87465(h)(2)	1 2 3 4 5 6 7	(h) The following requirements shall apply to medications which are centrally stored: (2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.	1 2 3 4 5 6 7	Prescriptions for medications were transferred to new pharmacy and facility is now utilizing bubble packs. Staff to obtain additional training for medication. Paperwork will be submitted to Department by plan of correction (POC) due date.
	8 9 10 11 12 13 14	**This was not met as evidenced by based on observation during facility tour, LPA observed Staff 3 (S3) dispensed medication into cups and had them placed in front of residents as they were seated at the dining room table and walked away	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda Medina	TELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

LIC9099 (FAS) - (06/04)

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