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32 | Regarding the allegation of residents being locked in their rooms, According to observations by SFDPH staff, during their initial visit on August 4, 2020, two residents were found in the designated isolation area (third floor). There was no staff readily available to attend to the needs of the residents on the floor. One resident appears to have been able to lock himself/herself in the room, and the other resident was non-ambulatory, unable to leave the room. Staff acknowledged that the residents are able to lock themselves in the rooms but denied that a resident had been purposely locked in the room. Staff acknowledged that due to the pandemic, staff checked on the residents through the window. Based on this information, there is preponderance of evidence that residents’ personal rights were violated when the residents were left unattended and unable to exit their rooms.
Regarding the allegations of facility failed to report changes, this allegation refers to the facility providing different and inconsistent information regarding the Covid-19 outbreak, resulting in inaccurate reporting and delayed responses. The current administrator was personally affected by the outbreak, requiring him to be out of the facility. Rather than hiring or finding a qualified replacement who could manage the emergency, the administrator attempted to run the facility remotely, resulting in inaccurate reporting and delaying swift resolution to concerns being found at the facility. Based on this information, there is preponderance of evidence that the facility failed to report changes due to the administrator not spending sufficient amount of time at the facility.
Based on LPAs observations and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.
Deficiencies cited under California Code of Regulations, Title 22 |