336426505-3-27-2024-18-AS-JDHS-D3TPQD-20240329113058

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426505
Report Date: 03/27/2024
Date Signed: 03/27/2024 10:38:35 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
02/12/2024 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20240212154137

FACILITY NAME:	STONEWALL GARDENS ASSISTED LIVING		FACILITY NUMBER:	336426505
ADMINISTRATOR:	LAUREN KABAKOFF		FACILITY TYPE:	740
ADDRESS:	2150 N PALM CANYON DR		TELEPHONE:	(760) 548-0970
CITY:	PALM SPRINGS	STATE: CA	ZIP CODE:	92262
CAPACITY:	35	CENSUS: 20	DATE:	03/27/2024
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Kitchen Manager, Brian Lebeuf		TIME COMPLETED:	10:50 AM

ALLEGATION(S):

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Staff are not transporting residents to medical appointments.
Administrator is not on the premises for a sufficient number of hours.
Facility is not following residents dietary plan.
Facility does not have a nurse available to assist residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Kathleen Banrasavong made an unannounced visit to the facility to deliver findings for a complaint investigation regarding the allegations listed above. LPA spoke to the Executive Director, Lauren Vincent over the phone and met with Kitchen Chef, Brian Lebuef and explained the purpose of the visit and the elements of the investigation. LPA Banrasavong conducted the investigation, which consisted of observation, interviews with staff members and residents, and record reviews. LPA was unable to interview additional witnesses in order to obtain pertinent information.
On 02/12/2024, Community Care Licensing received a complaint alleging that staff are not transporting residents to medical appointments, Administrator is not on the premises for a sufficient number of hours, facility is not following residents dietary plan, and facility does not have a nurse available to assist residents in care.
In regards to the allegations that staff are not transporting residents to medical appointments, LPA interviewed Resident (R1) and advised that they had no issues with obtaining any resources regarding their medical appointments and did not miss any medical appointments. It was also advised that there was always a Med Tech available and there were no issues or concerns. It was also alleged that the facility does not have a nurse available to assist residents in care. Marketing & Resident Enrichment Director, Brian Trout, stated the facility has six (6) med techs in total. There are different Med Techs for each shift, which accounts for the AM, PM, and weekend shifts.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-622-3619
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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-20240212154137

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: STONEWALL GARDENS ASSISTED LIVING	FACILITY NUMBER: 336426505
	VISIT DATE: 03/27/2024

NARRATIVE

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In regards to the allegation that the Administrator was not present at the facility for a sufficient number of hours, LPA reviewed the Administrator’s training and schedule. The Administrator stated that she is present at the facility and there to meet the needs to the residents. Information obtained from interviews with residents and staff stated there were no issues or concerns regarding Administrator being at the facility.

In regards to the allegations that the facility is not meeting resident’s dietary needs, after record reviews and interviews with administrator and staff, it was advised that there was no resident who resided at the facility, that required a special dietary plan or restriction. Head Chef, Brian Lebeuf corroborated that there were no residents that have any restrictions or special diets. It was advised that residents are able to substitute and have alternative meal options if they choose.

Based on LPAs observations, records review, and staff and resident interviews, this agency has investigated the complaint alleging that staff are not transporting residents to medical appointments, Administrator is not on the premises for a sufficient number of hours, facility is not following residents dietary plan, and facility does not have a nurse available to assist residents in care. 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, and a copy of this report was provided to the Executive Director, Lauren Vincent over the phone and provided to the Kitchen Chef, Brian Lebeuf as evidenced by his signature.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-622-3619
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC9099 (FAS) - (06/04)

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