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32 | (Continued from LIC9099)
According to Client #1’s (C1) physician report, C1 is diagnosed with Cerebral Palsy and requires full assistance with all activities of daily living (ADLs). Staff interviews and LPA observations confirmed that the facility provides access to a water cooler, which clients either use independently or with staff assistance to refill water bottles. Multiple staff interviews revealed that C1 is encouraged to hydrate throughout the day and has the right to refuse water intake. Staff described C1 as non-verbal but able to communicate needs through gestures or vocalizations. Staff confirmed that C1 requires full assistance with toileting and repositioning. C1 uses a wheelchair with a power movement function and wears a full back brace. Staff reported that they often adjust the wheelchair when C1 indicates discomfort, which they believe may be related to the brace. Staff also reported that they believe the position of the brace may occasionally cause the incontinence brief to leak, resulting in C1’s clothing becoming wet. When this occurs and is noticed, staff stated they change C1 immediately. LPA reviewed the staffing schedule against actual worked schedules and found the facility to be in compliance with Title 22 staffing requirements. Records review revealed that the facility does not maintain formal logs for hydration or incontinence care for C1. Interviews with outside sources, including family members of other clients with similar full-assist needs, revealed no reports of dehydration, toileting, or skin integrity concerns. While a few noted that their clients had occasionally returned home with a wet brief, they described these instances as rare.
Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
An exit interview was conducted with Program Director Munoz, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided. |