<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880511
Report Date: 11/05/2021
Date Signed: 02/10/2022 11:05:17 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2021 and conducted by Evaluator Shaunte Henry
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210202101506
FACILITY NAME:PALMS AT LA QUINTA, THEFACILITY NUMBER:
331880511
ADMINISTRATOR:PATRICK MCADOO-MORTONFACILITY TYPE:
740
ADDRESS:45160 SEELY DRIVETELEPHONE:
(760) 345-5353
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:120CENSUS: 103DATE:
11/05/2021
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Ruth FrommeTIME COMPLETED:
11:25 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not provide a safe environment for resident
Staff did not safe guard resident's personal property
Facility fed resident uncooked food
Facility was in disrepair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/5/21, Licensing program Analyst (LPA) Shaunte Henry conducted an unannounced visit for the purpose of delivering the finding to the above allegations, LPA met with Ruth Fromme, explained the nature of the visit and was granted entry.

The investigation, which consisted of interviews and document review revealed the following regarding Resident 1 (R1): The LPA was not able to interview R1 because they no longer reside at the facility:
Facility did not provide a safe environment for residents- Complaint details indicates R1 was not provided a call pendant. The call log indicates R1 pressed the call pendent 180 times in January of 2020. The LPA was not able to corroborate this allegation, therefore this allegation is unsubstantiated.
***continued on 9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte HenryTELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2021 and conducted by Evaluator Shaunte Henry
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20210202101506

FACILITY NAME:PALMS AT LA QUINTA, THEFACILITY NUMBER:
331880511
ADMINISTRATOR:PATRICK MCADOO-MORTONFACILITY TYPE:
740
ADDRESS:45160 SEELY DRIVETELEPHONE:
(760) 345-5353
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:120CENSUS: 103DATE:
11/05/2021
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Ruth FrommeTIME COMPLETED:
11:25 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff made inappropriate comments regarding resident
Staff did not treat resident with dignity and respect
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/5/21, Licensing program Analyst (LPA) Shaunte Henry conducted an unannounced visit for the purpose of delivering the finding to the above allegation, LPA met with Ruth Fromme, explained the nature of the visit and was granted entry.
The investigation, which consisted of interviews and file review revealed the following. An interview with the Executive Director (ED) revealed Staff 1 (S1) and Staff 2 (S2) made inappropriate comments in the presence of R1. The comments referred R1's body odor when toileting. S1 and S2 were placed on final warnings on 12/18/20 and were terminated. Based on LPA's observations and interviews, which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6) is being cited on the attached LIC9099D.An exit interview was conducted where this report and LIC 811, 9099D and appeal rights were provided to Ruth Fromme.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte HenryTELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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 4
Control Number 18-AS-20210202101506
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PALMS AT LA QUINTA, THE
FACILITY NUMBER: 331880511
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2022
Section Cited
CCR
87468.1(a)(3)
1
2
3
4
5
6
7
PERSONAL RIGHTS (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:
(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature...This requirement is not met as evidenced by...
1
2
3
4
5
6
7
The licensee will review the cited regulation, sign/date and provide proof to the department by the POC date.
8
9
10
11
12
13
14
Based on interviews and record review, Staff 1(S1) and Staff 2 (S2) made inapproproate comments while helping Resident 1(R1) during toileting.

This is a potential personal rights risk to residents in care.
8
9
10
11
12
13
14
Type B
02/17/2022
Section Cited
CCR
87468.2(a)(8)
1
2
3
4
5
6
7
ADDITIONAL PERSONAL RIGHTS To be free from neglect.. punishment, humiliation, intimidation, and verbal, mental abuse. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The licensee will review, sign/date the cited regulation and provide training to staff. Proof will be provided to the department by the POC date.
8
9
10
11
12
13
14
Based on interviews and record review, S1 and Staff S2 made inappropriate comments while toileting R1, which is considered a form of humilation. This is a potential personal rights risk to residents.
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: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte HenryTELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20210202101506
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: PALMS AT LA QUINTA, THE
FACILITY NUMBER: 331880511
VISIT DATE: 11/05/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
*** Continued from 9099***

Staff did not safe guard resident's personal belongings- An interview with the Executive Director (ED) revealed R1 reported an "old black phone" and a necklace with a ring on it were missing. The ED conducted interviews of 11 staff on the missing items. Staff confirmed observing a black phone in R1's apartment. All staff interviewed stated that they never observed a chain with a ring on it. The ED reported that the black phone was recovered inside of R1's apartment. The LPA was not able to corroborate this allegation, therefore this allegation is unsubstantiated.

Facility fed resident uncooked food- A family interview reported R1 being fed a "hard baked potatoe". During an interview, the ED denied serving R1 uncooked food. The LPA was not able to corroborate this allegation, therefore this allegation is unsubstantiated.

Facility was in disrepair- It was reported that there was a shower curtain placed between residents and visitors. During an interview, the ED stated that during the COVID-19 epidemic, it was mandatory that visitors and residents had limited direct contact during visitation at the facility. The facility was following the guidelines per Center for Disease Control (CDC) and Community Care Licensing (CCL). The LPA was not able to corroborate this allegation, therefore this allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated at this time. An exit interview was conducted where the 9099, 9099C and LIC 811 were provided to Ruth Fromme.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte HenryTELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4