336403366-5-22-2023-18-AS-JESL-CT2TEE-20230622143949

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336403366
Report Date: 05/22/2023
Date Signed: 05/22/2023 12:21:25 PM

Unsubstantiated

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
05/18/2023 and conducted by Evaluator Javina George

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230518105420

FACILITY NAME:	WINDSOR COURT ASSISTED LIVING		FACILITY NUMBER:	336403366
ADMINISTRATOR:	PATRICK MCADOO MORTON		FACILITY TYPE:	740
ADDRESS:	201 S. SUNRISE WAY		TELEPHONE:	(760) 327-8351
CITY:	PALM SPRINGS	STATE: CA	ZIP CODE:	92262
CAPACITY:	130	CENSUS: 129	DATE:	05/22/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Aurelien Fruit, Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff did not safeguard resident's belongings.

INVESTIGATION FINDINGS:

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Licesning Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation. LPA met with Aurelien Fruit, Administrator where LPA informed the purpose of LPA's visit and explained the elements of the allegation. The allegation was investigated, the investigation consisted of observation, interviews and record review.

Regarding the allegation of facility staff did not safeguard resident's belongings. Resident #1 (R1) was admitted to the facility on April 24, 2021. Per R1's personal property inventory form R1 was admitted with 1 pair of dentures. On May 6, 2023 while R1 was eating in th dining room, they were observed to appear to have been sleeping, and clammy. As a result R1 was sent out for medical observation. Upon R1's return to the facility on May 8, 2023, they were observed to have been without their dentures when eating breakfast. Interviews conducted with Staff #1 (S1) and staff #2 (S2) revealed that R1 stated that they had left their dentures at the hospital. Per the hospital inventory sheet R1 did not have their dentures with them. The facility staff report that R1 was sent out with their dentures and that they would not have been in the dining

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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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Control Number 18-AS-20230518105420

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: WINDSOR COURT ASSISTED LIVING	FACILITY NUMBER: 336403366
	VISIT DATE: 05/22/2023

NARRATIVE

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room without having their dentures in their mouth. Staff interviews also revealed that R1 did not request a special meal such as broth, and had the usual meals provided that was noted on the menu. Additionally, per the facility's theft and loss policy, the facility is not responsible for lost or stolen items. Based on interviews and record review the allegation of Facility staff did not safeguard resident's belongings is UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means that 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 a copy of this report was provided to Aurelien Fruit, Administrator.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC9099 (FAS) - (06/04)

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