336403366-4-30-2024-18-AS-JDHS-D5SQ46-20240531114947

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336403366
Report Date: 03/22/2024
Date Signed: 04/30/2024 03:33:39 PM

Unfounded

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
06/21/2021 and conducted by Evaluator Venus Mixson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210621122750

FACILITY NAME:	WINDSOR COURT ASSISTED LIVING		FACILITY NUMBER:	336403366
ADMINISTRATOR:	BRITTANY HOLM		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:	03/22/2024
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	ADMINISTRATOR, AURIELIAN FRUIT		TIME COMPLETED:	04:38 PM

ALLEGATION(S):

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Resident was not provided with an Admissions Agreement.
Staff are not administering medications to resident according to physicians orders.
Facility is overcharging resident in retaliation.

INVESTIGATION FINDINGS:

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On March 22, 2024, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced to deliver the findings and met with the Administrator. The visit was made to provide the findings for the investigation pertaining to the listed allegation. During the investigation, the LPA conducted staff and resident interviews, record reviews, and made observations pertaining to the listed allegation.

On June 21, 2021, Community Care Licensing received a complaint alleging a Resident (R1), was not provided with an Admissions Agreement. It was reported that R1 was not provided a copy of their Admissions Agreement upon the transfer from the California Nursing and Rehabilitation Center to the listed facility.

Regarding the allegation resident was not provided an admission agreement, it was advised that it is the policy and procedure to have each resident read, sign, and date their Admissions Agreement. Additionally, it was advised, if a resident is not able to sign and date the admissions agreement, then their responsible party may sign and date for the resident. The information obtained from interviews and record reviews does not corroborate the allegation.

Additionally, it was advised that R1 signed and dated the Admissions Agreement without assistance. A signed and dated Admission Agreement was observed and reviewed by the LPA during the record review.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus Mixson	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024

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-20210621122750

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: 03/22/2024

NARRATIVE

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CONTINUATION
Regarding the allegation, staff are not administering medications to resident according to physicians’ orders, it was advised that the facility staff followed the physicians’ orders and the medications on file as prescribed. Additionally, it was advised that when residents arrive to the facility the facility will make sure the medication orders are followed as prescribed by the physician. Finally, it was advised that it was not the current facility (referring to the listed facility), but the previous facility where R1 transferred from. The information received does not corroborate the allegation.

Regarding the allegation, facility is overcharging resident in retaliation the information obtained from interviews and record reviews, revealed that R1's insurance covered all services. It was advised that Hospice covered the wheelchair, along with additional services provided, and R1 did not have to pay for any services rendered. The information obtained does not support the allegation.

Based on information obtained from interviews, record reviews, and observations, the information obtained was not sufficient to demonstrate the listed allegations were valid. Therefore, the allegation has been deemed as unfounded, meaning the allegation is false, could not have happened, and/or is without a reasonable basis.

The Department has investigated, and the information obtained has demonstrated the listed allegations did not occur and therefore, has dismissed the allegations.

An exit interview was conducted, and a copy of this report was provided to the Administrator, Aurelien Fruit.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus Mixson	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2024

LIC9099 (FAS) - (06/04)

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