366426055-5-26-2023-56-AS-NBRN-CSLVYR-20230608165134

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366426055
Report Date: 05/26/2023
Date Signed: 05/26/2023 01:34:41 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
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/23/2023 and conducted by Evaluator Anna Bueno

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230523152910

FACILITY NAME:	BRIGHTWATER SENIOR LIVING OF HIGHLAND (DBA)		FACILITY NUMBER:	366426055
ADMINISTRATOR:	MARGUERITE CROCKEM		FACILITY TYPE:	740
ADDRESS:	28807 BASELINE STREET		TELEPHONE:	(909) 742-7353
CITY:	HIGHLAND	STATE: CA	ZIP CODE:	92346
CAPACITY:	115	CENSUS: 95	DATE:	05/26/2023
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Memory Care Director - Amber Nelson		TIME COMPLETED:	01:37 PM

ALLEGATION(S):

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Resident sustained unexplained injury while in care.
Staff leave residents in soiled diapers for extended periods of time.
Residents are being neglected while in care.
Staff failed to provide residents with clean linens.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility to investigate the complaint allegations above and deliver findings. LPA and met with Amber Nelson, Memory Care Director (MCD), who was informed of the reason for today’s visit and the elements of the allegation. Executive director (ED) Marguerite Crockem arrived shortly and was informed of the purpose the visit however ED left the memory care unit before the conclusion of the investigation. The investigation included LPA observations, staff and residents interviews, and records review.

Allegation 1: R1 sustained unexplained injury while in care. Interviews with staff deny that bruising was observed on R1's hands nor has their spouse who visits daily has spoken to staff about the bruising. Staff interviews also reveal that R1 is under hospice care and is visited by a shower nurse and a registered nurse regularly. LPA reviewed records showing that hospice visited R1 on 5/8/23, 5/9/34, 5/11/23, 5/15/23, and 5/23/23 and there are noted concerns from hospice during these visits. This allegation is therefore unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna Bueno	TELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023

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 56-AS-20230523152910

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
, CA 92507

FACILITY NAME: BRIGHTWATER SENIOR LIVING OF HIGHLAND (DBA)	FACILITY NUMBER: 366426055
	VISIT DATE: 05/26/2023

NARRATIVE

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Allegation 2: Staff leave residents in soiled diapers for extended periods of time. Resident interviews deny that they are left wet in soiled diapers for extended periods of time. Interviews with residents further reveal that they do not feel wet during this time. LPA observed residents to be clean and observed staff assist multiple ambulatory and non-ambulatory residents to the bathroom. LPA observed R2 ambulating with assistance. LPA visited rooms and found the rooms to be free from odor. This allegation is unsubstantiated.

Allegation 3: Residents are being neglected while in care. Resident interviews deny that they are being neglected. Interviews with residents further reveal that staff are fine and they are kept clean. LPA observed residents to be clean and tidy. Interview with staff confirm that there are usually two care staff working during NOC shift and four staff during AM and PM shifts. LPA inspected resident rooms and found them to be tidy and not cluttered. This allegation is therefore unsubstantiated.

Allegation 4: Staff failed to provide residents with clean linens. LPA inspected and observed room numbers 6, 7, 8, 10, 21, and 22 and found them to have clean linens. Interview with staff confirm that linens are provided by the resident and their care staff are responsible for washing the laundry as needed. LPA reviewed records showing that residents also have a scheduled laundry service 1-2 times a week. This allegation is unsubstantiated.

A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted with Ms. Nelson and a copy of this report was provided.

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Anna Bueno	TELEPHONE: 951-204-4307
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023

LIC9099 (FAS) - (06/04)

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