336403366-10-4-2023-18-AS-JDHS-CWGNFN-20231010102549

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336403366
Report Date: 10/04/2023
Date Signed: 10/04/2023 11:47:04 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE AC/SC, 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
08/07/2023 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20230807114540

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:	10/04/2023
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Administrator, Aurelien Fruit		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff did not provide adequate supervision resulting in resident suffering a fall and sustaining injuries.
Facility did not seek medical attention for a resident in care.
Staff left resident soiled for a long period of time.
Staff did not replace resident's bedding.
Staff did not dispose of resident's trash.
Staff refused to assist a resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kathleen Banrasavong made an unannounced visit to the facility to commence a complaint investigation regarding the allegation(s) listed above. LPA met with Administrator, Aurelien Fruit, where LPA explained the purpose of the visit and the elements of the allegation(s). The allegation(s) were investigated, the investigation consisted of observation, interviews with five (5) staff members and five (5) residents, and record review.
On 08/07/2023, Community Care Licensing received a complaint stating that the following allegations: Staff did not provide adequate supervision resulting in resident suffering a fall and sustaining injuries, Facility did not seek medical attention for a resident in care, Staff left resident soiled for a long period of time, Staff did not replace resident's bedding, Staff did not dispose of resident's trash, Staff refused to assist a resident in care.
(Continued on 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-248-0319
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

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-20230807114540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: WINDSOR COURT ASSISTED LIVING	FACILITY NUMBER: 336403366
	VISIT DATE: 10/04/2023

NARRATIVE

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(Continuation from 9099)
In regards to the allegation that staff did not provide adequate supervision resulting in residents suffering a fall and sustaining injuries, information obtained stated facility staff did not provide adequate supervision for the residents. It was also reported that the facility did not seek medical attention. Information obtained from interviews stated that residents are able to request assistance from facility staff when needed and obtain assistance within a reasonable time period. Through interviews obtained, the residents stated that they are able to get and receive medical attention if needed and no issues or concerns were advised.
It was also reported that staff left resident soiled for a long period of time and staff did not replace resident’s bedding. It was reported that an additional witness observed Resident #1 (R1) to be covered in feces while they were sleeping on separate occasions. It was reported that Resident’s bedding had vomit stains. It was also reported that staff did not dispose of residents’ trash. LPA observed resident’s bedding, trash, and room and deemed that it met the regulatory requirements. Through record reviews and staff interviews, LPA learned that there is a schedule where the staff changed bedding and takes out the trash. Residents can request to have it done more frequently, as needed. Interviews with residents corroborated the information obtained from staff. Information obtained from residents stated they can get assistance with changing briefs and bedding, in a reasonable. No issues or concerns were advised.
(Continued on 9099-C)

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-248-0319
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20230807114540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: WINDSOR COURT ASSISTED LIVING	FACILITY NUMBER: 336403366
	VISIT DATE: 10/04/2023

NARRATIVE

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(Continuation from 9099)

In regards to staff refusing to assist a resident in care, it was reported that staff refused to help residents get around the facility. During the LPA visit on 08/08/2023, residents indicated that they are able to ask for assistance and receive it.
Based on LPA’s observation, interview conducted and record review(s), the preponderance of evidence shows that the allegations of staff did not provide adequate supervision resulting in resident suffering a fall and sustaining injuries, facility did not seek medical attention for a resident in care, staff left resident soiled for a long period of time, staff did not replace resident's bedding, staff did not dispose of resident's trash, staff refused to assist a resident in care may have occurred, however is not supported or proven by evidence. Therefore, the allegations are unsubstantiated at this time.

An exit interview was conducted, a copy of this report, appeal rights was provided to the Administrator, Aurelien Fruit as evidenced by his signature.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-248-0319
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3