374602369-3-22-2023-08-AS-LTEZ-CQFSRT-20230331140651

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602369
Report Date: 03/22/2023
Date Signed: 03/22/2023 05:32:06 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/16/2022 and conducted by Evaluator Natasha Persaud

COMPLAINT CONTROL NUMBER: 08-AS-20221216100123

FACILITY NAME:	GOLDEN LIVING HEALTH MANAGEMENT, INC.		FACILITY NUMBER:	374602369
ADMINISTRATOR:	ROCIO GRANDA		FACILITY TYPE:	740
ADDRESS:	3223 DUKE STREET		TELEPHONE:	(619) 222-1109
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	113	CENSUS:	DATE:	03/22/2023
		UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Business Manager, Monica Cordoba		TIME COMPLETED:	04:10 PM

ALLEGATION(S):

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-Staff did not seek treatment for resident in a timely manner
-Staff do not respond to assist residents in a timely manner
-Administrator did not allow resident to return, once discharged from skilled nursing facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Natasha Persaud concluded the complaint investigation regarding the above mentioned allegations. LPA met with Business Manager, Monica Cordoba.

During the investigation, the facility was toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged staff did not seek treatment for Resident #1 (R1) in a timely manner. It was reported R1 had a rash from 9/22/22, possibly scabies and the facility did not ensure R1 received timely treatment for the rash, which extended through December 2022. R1’s Physician’s Report dated 06/02/21 indicated R1 was ambulatory and able to self- care with bathing, dressing/grooming, and feeding. R1’s Resident Appraisal dated 06/24/21 indicated R1 was ambulatory and required assistance with bathing supervision; assistance with dressing; and medication management. Outside source interviews revealed R1 had the rash as of 09/22/22 and they contacted the administrator on 09/28/22 to request a status for treatment. Facility records indicated the administrator was already working on timely medical treatment for all residents. Facility documentation reflected the facility’s physician wrote a prevention prescription dated 09/27/22 for all residents and staff involved with memory care as prevention measures. Continued on an LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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 08-AS-20221216100123

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: GOLDEN LIVING HEALTH MANAGEMENT, INC.	FACILITY NUMBER: 374602369
	VISIT DATE: 03/22/2023

NARRATIVE

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Administrator’s interview revealed the facility had to wait for the delivery of the medications and schedule the residents for treatment. Outside source interviews disclosed the administrator made them aware treatment for R1 was scheduled for 10/02/22. Facility records confirmed R1’s was scheduled for prevention treatment on 10/02/22 at 7:30pm with a shower date of 10/03/22 at 7:30am, which was performed and documented by the facility. The residents were treated on different dates in order to accommodate everyone since a shower was required the following day after treatment was provided.

R1’s spouse was responsible for taking R1 to their medical appointments, which was confirmed by the spouse and facility staff. R1’s spouse’s interview revealed they took R1 to the Dermatologist and a skin scraping was performed, R1 was not positive for scabies. R1’s spouse indicated R1 was taken twice to the Dermatologist due to the rash. However, the spouse was unable to obtain a diagnosis for the rash and was told it may have been an allergic reaction. R1’s spouse stated R1 was receiving timely treatment, as they were taking R1 to their medical appointments and the facility was treating R1 with a prevention prescription. The facility kept open communication with the spouse, as they were the responsible party for R1. R1 was sent to the hospital for a fever on 10/05/22. On 10/10/10, R1 was transferred from the hospital to a Skilled Nursing Facility (SNF). R1 remained at the SNF through 12/28/22 and did not return to the facility once discharged. Outside source interviews revealed R1 was not receiving timely treatment from the onset of the rash through December 2022. However, R1 was provided timely treatment on 10/02/22 and was taken to the hospital for a fever on 10/05/22 and did not return to the facility. The SNF was responsible for R1 from 10/10/22 through 12/28/22, as R1 was under their care and supervision. Interviews with outside sources revealed R1 was not diagnoses with scabies at the SNF but had a skin condition.

It was also alleged staff do not respond to assist residents in a timely manner. It was reported there was one occasion, date unknown, where an outside source called for assistance and it took twenty (20) minutes for staff to respond. Also, the outside source had difficulty locating staff to gain and/or exit the memory care unit, which required a code, date was also unknown. Resident interviews confirmed staff assist residents in a timely manner. The administrator explained there are three (3) staff per hallway assigned in the memory care unit. Administrator stated the memory care unit is not large, therefore, staff can get to residents quickly and hear the residents call out for assistance. Continued on an LIC 9099C.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20221216100123

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: GOLDEN LIVING HEALTH MANAGEMENT, INC.	FACILITY NUMBER: 374602369
	VISIT DATE: 03/22/2023

NARRATIVE

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The resident rooms have pull cords to call for assistance. However, due to the residents having a diagnosis of Major Neurocognitive Impairment, they forget to use the pull cord. Administrator stated the staff conduct checks on the residents every two (2) hours. Staff interviews revealed if the residents need something, they usually call out and staff respond quickly, within five (5) minutes. Administrator confirmed staff response time is usually five (5) minutes and less than ten (10) minutes. Outside source interviews revealed there was no indication of residents needing something and not receiving it. Lastly, it was alleged the administrator did not allow resident to return, once discharged from a Skilled Nursing Facility (SNF). It was reported R1 was not allowed to return to the facility after being discharged from the SNF in December 2022 due to having rashes. R1 went to a SNF on 10/10/22 and did not discharge to the facility. Outside source interviews revealed the facility sent a representative to the SNF on or around 11/16/22 to assess R1, so that they may return to the facility. Further outside source interviews revealed the facility told the outside source they cannot accept R1 back until the rashes are gone. The administrator’s interview revealed R1 was allowed to return to the facility and there was never a discussion R1 could not return to the facility. Administrator also stated she had no communication with the SNF, her staff was communicating with them. Staff that communicated with SNF explained R1 was waiting to be seen by a dermatologist, while at the SNF, due to a rash. Interviews confirmed the dermatologist was supposed to evaluate R1 at the SNF. There were some issues resulting in cancellation of the dermatologist, prolonging the evaluation. Outside source interviews confirmed the SNF was not made aware by the facility of refusal to take R1 back. Further outside source interviews revealed R1 was not ready for discharge in November 2022, when facility staff visited to assess. Facility staff were not aware of the discharge date as they were waiting to receive a discharge date from the SNF, which was never provided. R1 was discharged from the SNF on 12/28/22 and released to a family member by choice.

During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Business Manager, Monica Cordoba whose signature below confirms receipt of these rights.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC9099 (FAS) - (06/04)

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