On 10/3/2024, the Department interviewed S1 and S2. 2 out of 2 staff state that residents call for assistance are responded to in a timely manner. S2 states there have been longer wait times (up to 25 minutes) for pendant calls during peak hours (lunch time 11:30am to 12:30pm).

On 10/3/2024, LPA Tarin interviewed 5 residents. During interview, R1 pressed his/her pendant during the interview at 10:28AM, and staff to resident’s room at 10:29AM. R2 pressed his/her pendant at 10:37AM, and staff arrived at his/her room at 10:37AM.

On 10/9/2024, LPA Tarin interviewed 6 witnesses. W2-W6 state they have no concern with wait times and receive assistance in a timely manner. W1 states on one occasion their loved one had to wait more than 45 minutes on one occasion but could not state the day this incident occurred.

LPA Tarin reviewed pendant logs for R1 from 09/17/2024-10/3/2024. The pendant logs documents R1 pressing his/her pendant at least 5 times per day, and up to 20 times per day for assistance. The pendant logs do not have response times, but the resident’s pendant was being pressed for assistance.

It was alleged that facility staff are not treating residents with dignity. It was alleged that a staff member threw a banana on a table.

On 10/3/2024, the Department interviewed the ADM and S1 and S2. ADM, S1 and S2 state all residents are treated with dignity and respect. 2 out of 2 staff state they help each resident with their needs and provide assistance when residents press their pendants.

On 10/3/2024, the Department interviewed 5 residents. 5 out of 5 residents state they are treated with dignity. The Department interviewed 6 witnesses. W1-W6 state their loved ones are being treated with dignity and respect at the facility. W1 states their loved one is not being treated with dignity, that staff threw a banana on a table where her loved one couldn’t reach. W4 states he/she has seen staff engaged with residents, treating residents with respect. W6 states that staff are gentle and kind with their loved one.

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On 10/3/2024, the Department interviewed the ADM and S1 and S2. Adm states residents receive their medication on time, each resident’s medication is given per doctors’ orders. ADM states R1 does has a prescription for Tramadol, and it is a PRN (as needed) prescription. 2 out of 2 staff states resident are given medication based on the times needed for each individual resident.

On 10/3/2024, the department interviewed 5 residents. 5 out of 5 residents state they have no concerns with medications and received medication on time.

On 10/3/2024, the Department interviewed 6 witnesses. 5 out of 6 witnesses state they have no issues or concerns with medications administered to their loved ones. 1 out 6 witnesses state their loved one’s medication, Tramadol, was not administered per doctor’s orders.

On 10/3/2024, the Department reviewed 3 resident Medication Administration Records (MARs) and observed medication is being administered per doctor’s orders and given at the required times, initialed by staff. LPA Tarin reviewed physician’s order for R1’s Tramadol medication, which is PRN (as needed). Tramadol was given on 9/26/2024, and 9/27/2024 medication is as needed.

It was alleged that the facility did not provide services to meet the resident’s needs, staff do not know how to use a Hoyer lift on residents.

On 10/3/2024, the Department interviewed the ADM and S1 and S2. Adm states the facility has 2 residents that use a Hoyer lift, and staff are trained to use the lift. 2 out 2 staff state they have been trained to use the Hoyer lift.

On 10/3/2024, the department interviewed 6 witnesses. 3 out 6 witnesses state his/her loved one does not use a lift. 1 out of 4 witnesses state a lift is used on their loved one, and their loved one has no issues with the lift. 1 out 4 witnesses state they are not sure if their loved one uses a lift. 1 out of 6 witnesses state their loved one has expressed discomfort while being transferred out of his/her bed into their wheelchair.

Based on record review, the facility staff are using the Hoyer lift on 2 residents, to transfer out of their beds and into wheelchairs. Facility staff received training for the Hoyer lift on 7/15/2024.

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On 10/3/2024, the Department interviewed the ADM and S1 and S2. Adm states there are 3 staff on each shift (AM, PM, and NOC shift) daily. ADM states when they are short-staffed, the facility will call in staff that are not scheduled for that day, to come into work. 2 out 2 staff state there are always 3 staff on each shift, and if they are short-staff, staff who are not scheduled for the day are asked to come into work.

On 10/3/2024, the Department interviewed 6 witnesses. 5 out 6 witnesses’ state there are enough staff to meet residents needs. 1 out 6 witnesses state the facility does not have enough staff to meet their loved ones needs. W1 states on 9/24/2024, her loved one had to wait 45 minutes to get assistance with getting out of bed.

On 10/3/2024, the Department interviewed 5 residents. 5 out of 5 residents stated their needs are met.

LPA Tarin reviewed staff schedules for the month of September. 3 staff are scheduled per shift (AM, PM and NOC shift).

Based on the interviews conducted with residents, witnesses and staff and based on observation and records review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the above allegations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

On 10/3/2024, the Department interviewed S1 and S2. S1 and S2 states the facility has bingo, and exercise activities for the residents.

On 10/3/2024, the Department interviewed 5 residents. 5 out of 5 residents agreed to be interviewed. 5 out of 5 residents stated they facility offers activities.

On 10/3/2024, the Department interviewed 6 witnesses. 4 out of 6 witnesses state the facility provides activities for the loved ones, such as bingo, exercise, and sporting events (Super Bowl). 1 out 6 witnesses state he/she is a volunteer at the facility and sets up activities for residents. 1 witness states their facility does not provide activities.

During the day of the investigation, LPA Tarin observed residents in the living room area, watching TV and reading. LPA Tarin observed staff having conversation with residents, asking residents what activities they would like to do. Staff were also observed escorting residents from the dining area as they had finished having breakfast.

Based on record review and interview, the facility is providing activities for residents. Per September 2024 Activities Calendar, bingo is offered three times a week, exercise two times a week, Piano with Richard on Wednesdays, and ShowTime on Saturdays.

It was alleged that staff did not ensure resident was adequately hydrated.

On 10/3/2024, the Department interviewed ADM. ADM states there has not been a time when a resident was dehydrated.

On 10/3/2024, the Department interviewed S1 and S2, who states residents are offered water anytime they are checked on. 2 out of 2 staff state residents are given water and the staff will remind residents to drink water or juice. S2 stated there was a time a resident was dehydrated, and the resident’s family was informed, and resident was taken to doctor by family.

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On 10/9/2024, LPA Tarin interviewed 6 witnesses. W2-W6 states their loved ones are always offered water or have cups of water in their rooms. W5 states he/she sees staff going around the facility with cart offering water to residents. W6 states he/she has seen staff with a pitcher of water, offering residents water. W1 states their loved one’s lips were dry but didn’t state if resident was dehydrated.

During interviews with residents, LPA Tarin observed cups with water in residents’ room that were within reach of resident.

The Department has investigated the above allegations. Based on interview, record review and observation the above allegations are unfounded meaning the allegation is false, could not have happened and/or is without a reasonable basis. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Manger Daysi Calderon and a copy of the report was provided.

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