198601660-12-12-2022-28-AS-RORN-CMCNT3-20221222094405

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601660
Report Date: 12/12/2022
Date Signed: 12/12/2022 03:48:15 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2020 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20201105153416

FACILITY NAME:	POSADA AT WHITTIER		FACILITY NUMBER:	198601660
ADMINISTRATOR:	JANETTE HILL		FACILITY TYPE:	740
ADDRESS:	8120 S PAINTER AVE		TELEPHONE:	(562) 945-2651
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90602
CAPACITY:	0	CENSUS: 73	DATE:	12/12/2022
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Diana Bautista		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Facility staff posted a resident's picture online without consent.
Facility staff is not dispensing resident's medication as prescribed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint investigation to deliver findings on the allegations listed above. The facility closed on 12/7/2021. The purpose of the visit was explained to current Administrator Diana Bautista of new facility license POSADA SL LLC DBA La Posada 198603504.
POSADA SL LLC was the management company of former licensee KA-6 ASSOCIATES LLC.

The investigation consisted of the following: On 11/13/2020, due to the COVID-19 pandemic a virtual physical plant inspection of 1st, 2nd, 3rd floor common areas, as well as 1 resident room was conducted via FaceTime between 3:40 pm – 4:00 pm.Staff (S1- S5) were interviewed. Family Member (F1) was interviewed. Resident (R1's) file documents: [Identification and Emergency Information/Face Sheet, Admission Agreement, Physician Report, Resident Assessment/Appraisal/Needs and Services Plan, Personal Rights, Incident Report (date 5/13/20), email from Community Relations Director, Skin Integrity Monitoring Form (date 9/29/20), Medication Administration Records for Sept- Nov. 2020 were obtained. During today's visit, staff (S6 & S7) were interviewed.
See next page.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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

Control Number 28-AS-20201105153416

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: POSADA AT WHITTIER	FACILITY NUMBER: 198601660
	VISIT DATE: 12/12/2022

NARRATIVE

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Allegation: Facility staff posted a resident's picture online without consent. It is alleged that in August 2020 a female staff (S4) member took pictures and video recorded another staff (S5) making fun and addressing one resident (R2) in a derogatory manner by using curse words. A total of four (4) Dementia/Memory Care residents were observed in the video that was posted on Snapchat social media, and then reposted on Facebook. Based on interviews conducted, the findings indicate that the four (4) residents on the video did not consent to online picture/video post by staff members. Staff (S4) and staff (S5) acknowledged they acted in an unprofessional and inappropriate behavior by posting pictures and video recording the residents. All staff interviewed confirmed the actions. Former Administrator staff (S1) stated that staff (S4 & S5) broke privacy policy and violated the resident's rights. Staff were suspended, counseled and given a final warning. The families of the residents were notified. Both staff involved were required to contact the resident's families and apologize for the incident.

Allegation: Facility staff is not dispensing resident's medication as prescribed. It is alleged that the facility is not dispensing resident (R1's) medications as prescribed by MD. Resident (R1) is a Memory Care resident that has sundowning behavior and on those days the resident refuses to take medications staff do not administer the medications if the resident is asleep or has refused to take the medications. Five (5) out of five (5) staff interviewed denied the allegation. However, staff confirmed that during months Sep 2020 - Nov 2020 the Electronic Medication Administration Records (EMAR) show that on some days the medications were not administered or signed off by staff indicating that the medications were not dispensed as ordered by R1's physician. Staff stated that the facility has experienced internet problems that may have affected the EMAR records. However, paper Medication Administration Records were not submitted to LPA, and there is no record that the facility notified R1's MD to report the missed medications. LPA obtained EMAR records indicating medications were missed.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22.

Exit interview was conducted with Administrator Diana Bautista. A copy of the report and appeal rights were issued.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20201105153416

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: POSADA AT WHITTIER	FACILITY NUMBER: 198601660
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/12/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/12/2022 Section Cited CCR 87465(a)(5)	1 2 3 4 5 6 7	Incidental Medical and Dental Care Services. The licensee shall assist residents with self-administered medications when needed. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administration staff shall ensure all med-tech staff distribute medications as ordered by MD. Adminsitrator submitted proof of medication staff training conducted on Nov. 18, 2022. ***CLEARED today.
	8 9 10 11 12 13 14	Based on record review, R1 was not administered all medications ordered by MD between months Sep 2020- Nov. 2020. EMAR records showed that on some days staff did not sign off that the meds were given, or that R1 refused medications. This poses an immediate health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14
Type B 01/09/2023 Section Cited CCR 87468.1(a)(1)	1 2 3 4 5 6 7	Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met evidenced by:	1 2 3 4 5 6 7	Administration staff shall ensure that the resident's privacy rights are adhered to, and staff facility policies regarding social media and phone use during work hours. Submit proof of staff training and written warning issued to staff (S4 & S5).
	8 9 10 11 12 13 14	Based on interviews conducted the findings indicate that staff (S4) posted a video recording on Snapchat that got reposted on Facebook, in which R2 was cursed; 3 other residents were seen in the video. This violates the resident's right to privacy. This poses a potential health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14

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: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

LIC9099 (FAS) - (06/04)

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