336412441-4-17-2023-18-AS-EMAN-CRBP2V-20230428105635

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336412441
Report Date: 04/17/2023
Date Signed: 04/17/2023 12:56:44 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
10/19/2020 and conducted by Evaluator Ryan Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20201019120418

FACILITY NAME:	HALLMARK-PALM SPRINGS		FACILITY NUMBER:	336412441
ADMINISTRATOR:	GLORIA GOURLAY		FACILITY TYPE:	740
ADDRESS:	344 NORTH SUNRISE WAY		TELEPHONE:	(760) 322-3955
CITY:	PALM SPRINGS	STATE: CA	ZIP CODE:	92262
CAPACITY:	55	CENSUS: 44	DATE:	04/17/2023
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Gloria Gourlay- Administrator		TIME COMPLETED:	01:07 PM

ALLEGATION(S):

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Resident are left soiled for extended periods of time while in care.
Staff retained a resident with a prohibited health condition.
Residents records are inadequate.
Staff are mishandling residents medications.
Facility is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Ryan Gardner and Mary Rico conducted an unannounced visit to the facility to investigate and deliver findings for the above complaint allegations. LPA met with Administrator Gloria Gourlay and explained the reason for the visit. The visit consisted of interviews, document review, and a facility tour.

For allegation, Resident are left soiled for extended periods of time while in care:

During interviews with residents, the residents did not indicate that they were left in diapers for an extended period of time. The residents stated that they were checked on frequently by the staff and or they took care of their own incontinence needs.

During interviews with staff, the staff denied leaving residents in soiled diapers for an extended period of time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 248-0336
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

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-20201019120418

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: HALLMARK-PALM SPRINGS	FACILITY NUMBER: 336412441
	VISIT DATE: 04/17/2023

NARRATIVE

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The staff completes room checks on each resident as often as one (1) to two (2) hours. If a resident needs a diaper change in between room checks, the resident presses their call pendant, and a staff will come change their diaper within five (5) to ten (10) minutes. The staff stated they have not received any complaints from the residents regarding their soiled diapers.

For allegation, Staff retained a resident with a prohibited health condition:

During document review, LPAs discovered that the facility did retain a resident with a prohibited health condition. The resident’s prohibited health condition was allowed per the resident’s hospice care order. The hospice company was taking care of the prohibited health condition. The facility was not responsible for the care of the prohibited health condition.

For allegation, Residents records are inadequate: It was alleged that the resident’s records were not locked properly.

During facility tour, LPAs were shown a locked office where the residents records were properly secured.

For allegation, Staff are mishandling resident’s medications: It was alleged that the residents were not receiving their medications on time.

During interviews with staff, staff denied that residents medications were not given to residents on time. The staff indicated that their computer system notifies them what time each resident needs their medications. The staff checks the system for the correct time to deliver medication prior to dispensing.

During interviews with residents, the residents stated that there were no issues with their medication and medication was delivered to them at the appropriate time.

During document review, LPAs reviewed residents’ medication records (MARs) and did not find notes detailing late medications.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 248-0336
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20201019120418

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: HALLMARK-PALM SPRINGS	FACILITY NUMBER: 336412441
	VISIT DATE: 04/17/2023

NARRATIVE

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For allegation, Facility is in disrepair: It was alleged that the facility ceiling was leaking water.

During interview with staff, staff informed LPAs that there was a leak in the main hallway ceiling, and they contacted a company to come repair the issue.

During document review, LPAs discovered that the facility contracted a company to come repair a leak in the main front hallway. The company repaired the leak and installed new dry wall to ensure the leak was repaired. The facility took the necessary steps to ensure the leak was repaired and safe for the residents.

Based on the evidence found during the investigation, the five (5) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report was discussed and provided to Administrator Gloria Gourlay, along with a copy of the appeal rights.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 836-2784
LICENSING EVALUATOR NAME: Ryan Gardner	TELEPHONE: (951) 248-0336
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC9099 (FAS) - (06/04)

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