336403366-10-16-2023-18-AS-JDHS-CWPVH7-20231017162641

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336403366
Report Date: 10/16/2023
Date Signed: 10/16/2023 11:21:51 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
08/18/2023 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20230818125146

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: 130	DATE:	10/16/2023
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Administrator, Aurelien Fruit		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff are not following resident's care plan
Staff mismanaged resident's medication

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 allegations listed above. LPA met with Administrator, Aurelien Fruit, and explained the purpose of the visit and the elements of the allegations. LPA Banrasavong conducted the investigation which consisted of observation, interviews with staff members and residents, and record review.
On 08/18/2023, Community Care Licensing received a complaint stating that facility staff are not following resident's care plan and staff mismanaged resident's medication.
In regards to the allegation that staff did not follow the residents care plan, it was reported that the facility did not follow orders from Above and Beyond Hospice for Resident #1. The order was for medication queued date of 08/10/2023. Medication was never given or distributed due to the facility not receiving order and directions to distribute the medication. Information obtained from interviews and record reviews, show that the facility did not receive orders to distribute the medication to Resident #1. The request for orders to be provided was made by the facility until the resident’s medical condition had subsided. Through interviews conducted, LPA concluded that the facility had procedures in place before giving medication and has followed the resident’s care plan.
(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: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

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-20230818125146

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: 10/16/2023

NARRATIVE

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(Continuation from 9099)
In regards to the allegation that staff mismanaged resident's medication. It was reported that the facility staff did not give medication to Resident #1. LPA learned that the proper orders were never provided to the facility and per facility procedures, medication will not be distributed without proper orders. Medication was properly destroyed and logged. The record shows the medication were queued in the facility’s digital log on 08/10/2023. When Resident #1’s medical issues occurred again, the facility reported it to hospice. Facility staff made the request to hospice to provide a new order and mediation be sent for the Resident #1’s condition. The request was denied by hospice, due to hospice stating that they already sent the medication and order for Resident #1’s medical issue. However, the facility had destroyed the medication due to no orders being sent and the resident’s condition improving on its own. Per facility protocols, all medication is destroyed, that are not being used or that do not have orders attached to them.
Based on LPA’s observation, interview conducted, and record reviews, the preponderance of evidence shows that the allegations of staff are not following resident's care plan and staff mismanaged resident's medication is not supported or proven by evidence. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

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: 10/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023

LIC9099 (FAS) - (06/04)

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