405850034-2-3-2023-29-AS-KBUY-CP44TM-20230215182322

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 01/11/2023
Date Signed: 02/03/2023 12:58:24 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/18/2022 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20221018134556

FACILITY NAME:	AVILA SENIOR LIVING AT DOWNTOWN SLO		FACILITY NUMBER:	405850034
ADMINISTRATOR:	KAREN ENCISO		FACILITY TYPE:	740
ADDRESS:	475 MARSH ST		TELEPHONE:	(805) 541-4222
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	100	CENSUS: 53	DATE:	01/11/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Erika Hampe, Administrator		TIME COMPLETED:	06:20 PM

ALLEGATION(S):

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Insufficient staffing to meet residents’ needs

INVESTIGATION FINDINGS:

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This is an amended report. On 1/11/23 at 2:00 pm, Licensing Program Analyst (LPA) Darlene Chavez conducted an unannounced complaint investigation visit to the facility listed above to deliver final findings. LPA met with Erika Hampe, Administrator, and explained the purpose of the visit.

On the allegation “Insufficient staffing to meet residents’ needs,” the complainant was concerned that residents are not getting their showers as scheduled and sometimes have to wait as much as a week. To investigate, LPA interviewed the administrator, staff and witnesses, and reviewed records.
On 10/14/22 at 12:45 pm, LPA interviewed staff, who described staffing as “short” and that med-techs were making errors because they were being pulled into caregiving duties quite often and could not focus on their jobs.
On 10/20/22 at 3:40 pm, LPA spoke with Erika Hampe, Administrator. The administrator states that the caregiver schedule appears to have enough coverage and that caregivers are the staff who assist residents with showers. Continued on 9099-C.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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 29-AS-20221018134556

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AVILA SENIOR LIVING AT DOWNTOWN SLO	FACILITY NUMBER: 405850034
	VISIT DATE: 01/11/2023

NARRATIVE

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On 1/11/23 at 3:00 pm, LPA reviewed resident records. Resident Summaries indicate the days and times residents are scheduled to receive showers. Care Staff Assignments indicate the days and times when caregivers completed this task between the dates of 10/2/22 and 10/23/22. During this period, there were fifty-four (54) occasions when a resident was scheduled for a shower and did not receive it or the caregiver arrived early or late to assist the resident. At 3:15 pm, LPA discussed with the Administrator the fact that one resident had only gotten a couple of showers at the beginning of the month, and the administrator stated, “I think this resident might have passed away. I’ll have to look.” LPA also reviewed Family Council Meeting Minutes from 9/30/22 where the Council members state their concerns, “If residents need assistance with showers/bathing how many times per week is this service provided? Presently many families report that showers/baths are not being supervised or provided per care plans. We have heard many complaints that residents are not getting showers as scheduled and at the times residents prefer.

LPA interviewed Administrator again on 2/3/23 about the showers that were missed and asked the Administrator why the showers would have been missed if she believes the facility had sufficient staffing. Administrator states that caregiver documentation is inconsistent, and it is unclear whether some resident showers were completed. She checked to see if any residents had changes to their showering schedule and if residents passed away or moved out during the time period reviewed, and Administrator did not find any changes. Administrator states she is working with Wellness staff to update the documentation and process for recording completed showers.

On 9/12/22 between 3:39 pm and 9:28 pm, Witnesses interviewed communicated their concerns to LPA. Witness states that there are concerns with the timeliness of showers, laundry, housekeeping and meal service. Witness specifies they are hopeful that when the facility is fully staffed and new staff are trained there will be shorter wait times for showers and meal service.

On 1/19/23 and 1/27/23, LPA interviewed staff and residents. Staff say that it’s difficult to get to the laundry, showers, and bedding because there aren’t enough caregivers. Residents say they would like showers more often, if there were more staff.

Based on evidence obtained, the allegation “Insufficient staffing to meet residents’ needs” is Substantiated at this time. Interviews and records reveal that the facility is not meeting the needs of residents regarding showering services.

Exit interview conducted, deficiency cited, and the report and appeal rights emailed to administrator.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20221018134556

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AVILA SENIOR LIVING AT DOWNTOWN SLO	FACILITY NUMBER: 405850034
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/11/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/12/2023 Section Cited CCR 87468.1(a)(2)	1 2 3 4 5 6 7	87468.1(a)(2) Personal Rights of Residents in All Facilities: (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This regulation was not met as evidenced by:	1 2 3 4 5 6 7	Administrator will send a commitment to CCL by 1/12/23 stating she will send CCL a weekly staff schedule, an actual schedule of staff who worked the previous week, and reasons for staff not completing their shift(s). Administrator has committed to sending these documents to CCL until CCL determines the facility has adequate staffing to meet resident needs.
	8 9 10 11 12 13 14	Based on interviews and records review, the licensee failed to ensure residents were given showers as scheduled which poses an immediate health and safety risks to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC9099 (FAS) - (06/04)

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