331880511-6-15-2023-18-AS-KCLS-CSZP2Q-20230621105620

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880511
Report Date: 06/15/2023
Date Signed: 06/15/2023 10:52:07 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/22/2021 and conducted by Evaluator Rayshaun Nickolas

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210622124223

FACILITY NAME:	PALMS AT LA QUINTA, THE		FACILITY NUMBER:	331880511
ADMINISTRATOR:	PATRICK MCADOO-MORTON		FACILITY TYPE:	740
ADDRESS:	45160 SEELY DRIVE		TELEPHONE:	(760) 345-5353
CITY:	LA QUINTA	STATE: CA	ZIP CODE:	92253
CAPACITY:	120	CENSUS: 98	DATE:	06/15/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Roland Gandy, Executive Director		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff member is not following resident's doctor's orders.
Staff member inappropriately handled resident causing bruising.
Staff member spoke inappropriately in front of resident.
Resident is made to wait an excessive amount of time for assistance.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rayshaun Nickolas visited the facility unannounced to deliver the finding on the above allegations. LPA met with Executive Director Roland Gandy and explained the purpose of the visit. Department staff investigated these allegations.

Allegation #1 “Staff member is not following resident's doctor's orders”. The allegation alleged that staff #1 (S1) administers resident #1 (R1) breathing treatments when S1 wants to not, according to the physician’s orders. Department staff interview with the administrator revealed that S1 follows the physician’s orders with all medications and treatments. Department staff interview with S1 revealed that S1 denied this allegation. S1 stated they are giving R1 their medication according to the physician’s order. Department staff interview with R1 revealed that to the best of R1’s knowledge, S1 provided breathing treatments as ordered by their physician. R1 stated that they do not recall missing any breathing treatments or sustaining adverse health effects.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Rayshaun Nickolas	TELEPHONE: (951) 255-9516
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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 18-AS-20210622124223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: PALMS AT LA QUINTA, THE	FACILITY NUMBER: 331880511
	VISIT DATE: 06/15/2023

NARRATIVE

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Department staff file review revealed that according to R1’s Medication Administration Records (MARs), R1 had no missed doses of their breathing treatments. The finding is unsubstantiated. There is no evidence or witnesses to corroborate the allegation.

Allegation #2 “Staff member inappropriately handled resident causing bruising”. The allegation alleged that S1 jerked R1 out of bed, leaving bruises on R1’s arm. The allegation alleged that R1 asked S1 not to jerk them so hard. Department staff interview with the administrator revealed that the administrator denied this allegation. Department staff interview with R1 revealed that they did not recall S1 jerking them out of bed, causing bruising. The finding is unsubstantiated. There is no evidence or witnesses to corroborate the allegation.

Allegation #3 “Staff member spoke inappropriately in front of resident. The allegation alleged that the reporting party (RP) was visiting R1 at the facility for lunch. The allegation alleged that the RP informed one (1) of the nurses at the facility that R1 was not hungry right now and requested that they return later with an Ensure for R1. The allegation alleged that the nurse informed S1, and S1 told the RP that they could not speak for R1; S1 stated that R1 needed to “speak up.” The allegation alleged that a relative of the RP told S1 to leave the room, and S1 stated: “that they will have the admin drag the RP's relative out the front door". Department staff interview with the administrator revealed that the RP, and the RP's relative were yelling at S1. Department staff interview with S1 revealed that S1 was called to R1’s room by another member of the facility’s staff because the RP and the RP’s relative were yelling in that staff’s face. S1 stated that they tried to resolve the situation, but the RP and RP’s relative became verbally abusive and yelled at S1. S1 stated that they informed the RP and the RP’s relative that if they did not calm down, S1 would ask the administrator to remove them from the building and possibly make future visits. Department staff interview with R1 revealed that S1 has never spoken inappropriately in front of them or towards them. Department staff interview with resident # 2 (R2) revealed that they have never experienced staff speaking inappropriately in front of or to them. Department staff interview with resident #3 (R3) revealed that they also have never experienced staff speaking inappropriately in front of or to them. The finding is unsubstantiated. There is no evidence or witnesses to corroborate the allegation.

Allegation #4 ‘Resident is made to wait an excessive amount of time for assistance”. The allegation alleged that R1 usually has to wait a long time before receiving assistance which causes R1 to urinate on themself. Department staff interview with the administrator revealed that the administrator denied this allegation.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Rayshaun Nickolas	TELEPHONE: (951) 255-9516
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20210622124223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: PALMS AT LA QUINTA, THE	FACILITY NUMBER: 331880511
	VISIT DATE: 06/15/2023

NARRATIVE

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Department staff interview with R1 revealed that R1 does not recall waiting an excessive period for staff assistance. Department staff interview with R2 stated that they rarely use their call pendant. However, R2 stated the one (1) time they did, the staff responded in a reasonable amount of time. Department staff interview with R3 revealed that they used their call pendant “a couple of times,” and the staff always responds promptly. Department staff file review of the facility’s call pendant report for June 2021 revealed that the average response time was between three (3) and twelve (12) minutes. The call pendant report for June 2021 also revealed that only four (4) days in the entire month of June did the response time average between nine (9) and twelve (12) minutes. The finding is Unsubstantiated. There is no evidence or witnesses to corroborate the allegation.

A finding of unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted and copy of this report was provided.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Rayshaun Nickolas	TELEPHONE: (951) 255-9516
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

LIC9099 (FAS) - (06/04)

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