405850034-6-20-2024-29-AS-KBUY-D6MPWD-20240627114035

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 06/20/2024
Date Signed: 06/20/2024 02:05:53 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, 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
11/30/2023 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20231130160914

FACILITY NAME:	AVILA SENIOR LIVING AT DOWNTOWN SLO		FACILITY NUMBER:	405850034
ADMINISTRATOR:	DARLENE MARKHAM		FACILITY TYPE:	740
ADDRESS:	475 MARSH ST		TELEPHONE:	(805) 541-4222
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	100	CENSUS: 49	DATE:	06/20/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Darlene Markham, Administrator		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff did not seek timely medical attention for resident.
Staff did not assist resident with obtaining prescribed medication.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) De Leon conducted a subsequent complaint visit to the facility above to deliver final findings of the complaint investigation. LPA met with Darlene Markham and explained the purpose of the visit.

LPA De Leon conducted the initial 10 day visit on 12/01/2023, requested records and interviewed staff at 1:15pm, 1:30pm, 1:45pm and 2:15pm. LPA interviewed residents on 5/14/24 in the afternoon, 5/16 at 11:15am and 11:56am, 5/28/24 at 1:40pm, and 05/30/2024 at 11:09am.

On the allegation: Staff did not seek timely medical attention for resident. LPA De Leon conducted interviews with residents which revealed, R1 is independent and does not have a care plan with the facility that includes medication management, R1 handles own medications. R1 does not recall date of fall but does recall asking for a ride to the ER, R1 thinks is may have been the same day,

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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 29-AS-20231130160914

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: 06/20/2024

NARRATIVE

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R1 did not want 911 called or an ambulance and refused that service, R1 did ask for a ride in the transportation van but staff told R1 that it was no longer running that day and the driver went home already, the staff offered a Uber ride and R1 said they already asked a friend to take R1. R1’s friend did take R1 to the ER and Rand 1 did have broken ribs. R1 recalled falling at the facility out front in the parking lot by the bricks on the curb but could not recall the exact date or time or weather R1 informed the staff immediately or the next day, R1 was discharged with prescription to pick up at pharmacy.

Staff interviews stated resident asked for a band aide the night before but never reported a fall, the resident asked to go to the ER the next day but refused 911 services to be called and wanted non-urgent transportation but R1 had found a ride before staff could arrange.

Based on the evidence this allegation is deemed Unsubstantiated at this time.

On the allegation: Staff did not assist resident with obtaining prescribed medication. LPA interviewed staff revealed if the resident is not on a care plan for medication management and the resident handles their own medications, they need to pick them up themselves or have a friend pick them up for them. They can put in for the transportation van to take them to pick them up but at this time the driver was off work and the van was not running, Uber was offered. Staff are not allowed to pick up medications and or pay for them with resident’s funds, it is a liability, and the prior staff was not supposed to do it. Interview with residents revealed R1 was independent and handled all R1’s own medications. R1 picks up own medications or has friends pick up medications. R1 can not recall what was said that day but R1 did have a friend pick up R1’s medications.

Based on the evidence this allegation is deemed Unsubstantiated at this time.

Exit interview conducted and copy of report printed for administrator.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

LIC9099 (FAS) - (06/04)

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