385601084-8-8-2024-14-AS-KHOS-D8HKL9-20240826075933

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 385601084
Report Date: 08/08/2024
Date Signed: 08/08/2024 10:14:38 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/16/2024 and conducted by Evaluator Grace Donato

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20240716165634

FACILITY NAME:	LYNNE & ROY M FRANK RESIDENCES		FACILITY NUMBER:	385601084
ADMINISTRATOR:	TANG, EDWINA		FACILITY TYPE:	740
ADDRESS:	ONE AVALON AVENUE		TELEPHONE:	(415) 562-2855
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94112
CAPACITY:	220	CENSUS: 175	DATE:	08/08/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Sandra Peret, Edwina Tang, Rob Sarison		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Licensee does not ensure sufficient staffing to meet residents’ care needs

INVESTIGATION FINDINGS:

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On 8/8/24, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint investigation visit. LPA met with Sandra Peret, Edwina Tang, Rob Sarison and explained the purpose of today's visit.

Regarding the allegation of Licensee does not ensure sufficient staffing to meet residents’ care needs., Reporting Party (RP) stated that the residents in the memory care unit, especially those who cannot speak, are being neglected by staff because the facility is short staffed, so the residents’ care needs are not being met. RP states the residents are often left in their rooms and forgotten about.

LPA was able to interview RP, and an additional information was provided stating that a resident (R1) who stays in memory care always sleeps in the room and doesn't get fed. You can tell every time you go that there is not enough staff. Sometimes the caregivers who are in memory care goes to assisted living.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

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 14-AS-20240716165634

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LYNNE & ROY M FRANK RESIDENCES	FACILITY NUMBER: 385601084
	VISIT DATE: 08/08/2024

NARRATIVE

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LPA interviewed four staff members. All mentioned that there is no issue with regards to staffing in the facility. A staff, S3, mentioned that if there are call outs it still gets covered. Staff are also able to manage feeding without issues. Each staff interviewed has 4 to 5 residents assigned under their care. S2 also mentioned that if needed, calls another person for additional assistance. During the interview, S1 also mentioned that there is a resident (R1), has been slow in responding and can't balance anymore, eats a little bit and slowly eats or chews. S2 also confirmed that R1 is a non-verbal resident, a slow eater and has difficulty in feeding. R1 used to attend activities before and sometimes participates depending on the condition. S5 stated that there are floaters who can work both in memory care and assisted living. They are cross trained in case needed.

Based on records review, the facility provided the schedule in memory care unit there is currently 4 neighborhoods where residents live. For each neighborhood there are two to three caregivers (depending on the number of residents). Aside from that there is also a nurse on shift, three med techs, two floaters and activity coordinators. LPA also checked the progress notes and meal logs for R1 and it showed that R1 is eating less and less. Records also show that facility reached out to responsible party regarding R1’s slow decline and referral to hospice.

Based on interviews & records review, the department has determined that 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, therefore the allegation is UNSUBSTANTIATED.

Report is reviewed and copy is provided.

SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

LIC9099 (FAS) - (06/04)

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