455002764-7-27-2023-59-AS-KHOS-CUSGQS-20230817053311

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 455002764
Report Date: 07/27/2023
Date Signed: 07/27/2023 03:18:48 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/24/2023 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20230424132145

FACILITY NAME:	SAINT LORENZ ASSISTED LIVING		FACILITY NUMBER:	455002764
ADMINISTRATOR:	BIRD, JAMES		FACILITY TYPE:	740
ADDRESS:	740 LAKE BLVD		TELEPHONE:	(650) 632-5300
CITY:	REDDING	STATE: CA	ZIP CODE:	96003
CAPACITY:	17	CENSUS: 14	DATE:	07/27/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Shirl Freeman - facility manager		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff do not seek timely medical care for residents in care - UNSUBSTANTIATED
Staff do not provide proper medication assistance to residents in care - UNSUBSTANTIATED
Residents are left in urine for an extended amount of time - UNSUBSTANTIATED
Residents are left on the floor for an extended amount of time - UNSUBSTANTIATED
Staff do not provide proper food service to residents in care - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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07/27/2023 01:00 PM Licensing Program Analyst (LPA's) Rebecca Knight and Sarah Benson made an unannounced visit to the facility and met with facility manager Shirl Freeman. The purpose of this visit was to deliver the results of a complaint investigation.
During the course of the investigation the licensee/administrator, and 5 staff were interviewed. LPA requested and reviewed the following documents: related incident reports, EMAR, Physician’s report, Admission Agreement, for 1 resident, staff list with telephone numbers, client list.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

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 4

Control Number 59-AS-20230424132145

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SAINT LORENZ ASSISTED LIVING	FACILITY NUMBER: 455002764
	VISIT DATE: 07/27/2023

NARRATIVE

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Page 1

Staff do not seek timely medical care for residents in care. - UNSUBSTANTIATED

It was reported that residents aren't taken to the doctors as soon as is needed.

4 of 5 staff stated that residents are taken to see their doctor right away or as soon as possible if needed. 1 staff stated they had never been in that situation and did not know. 1 staff stated the only appointments that took time to get are denture and ophthalmic appointments due to a wait list.

Administrator stated It depends on the nature of the care needed. If it is urgent we have a doctor that comes to the facility. If it is critical we take them ourselves or call for medical transport..

This allegation is unsubstantiated.

Staff do not provide proper medication assistance to residents in care. - UNSUBSTANTIATED

It was reported that staff are asked to pre-fill medication, and staff with no training are made to pass them sometimes resulting in wrong person getting meds.

3 of 5 staff stated they had not been instructed to pre-fill medications. 1 of 5 staff stated they had been asked to pre-fill medications 24 hours in advance. 1 of 5 staff stated they did not work with medications.

Administrator stated We have been continuing to do the 24-hour med poor. The only exception are hospice residents with pre-drawn and pre marked medication by their RN.

This allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 59-AS-20230424132145

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SAINT LORENZ ASSISTED LIVING	FACILITY NUMBER: 455002764
	VISIT DATE: 07/27/2023

NARRATIVE

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Page 2

Residents are left in urine for an extended amount of time. - UNSUBSTANTIATED

It was reported that there is not enough staff to cover NOC shift leaving residents in urine.

4 of 5 staff stated they had not witnessed or heard about residents being left in urine for an extended amount of time. 1 of 5 staff stated they have come in and found the residents really wet.

Administrator stated Typically, we have 2 staff until 8:00 or 9:00 pm and then until 6:00 am we have one awake on duty staff and a second staff person lives 15 minutes away if needed. The overnight staff take a break onsite and the expectation is that sometime between their start and end shift there would be 30 minutes they could take a break in the general dining area.

This allegation in unsubstantiated.

Residents are left on the floor for an extended amount of time. - UNSUBSTANTIATED

It was reported that there is not enough staff to cover NOC shift leaving residents on the floor for long periods of time.

5 of 5 staff stated they had not witnessed or heard of any residents being left on the floor for an extended period. 3 of 5 staff stated that they have to call the fire department for lift assistance if a resident falls.

Continued on LIC9099-C

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 59-AS-20230424132145

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SAINT LORENZ ASSISTED LIVING	FACILITY NUMBER: 455002764
	VISIT DATE: 07/27/2023

NARRATIVE

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Page 3

Staff do not provide proper food service to residents in care. - UNSUBSTANTIATED

It was reported that staff are told not to feed residents that need help being feed resulting In them losing weight or going hungry.

5 of 5 staff stated if a resident requires help eating they will sit with the resident, assist them with guiding their hand to their mouth to feed themselves and make sure the resident chews and swallows. 5 of 5 staff stated no residents have gone hungry or lost weight due to not being able to feed themselves.

Administrator stated Everything is dependent on the resident’s care plan, all staff are aware. If we have a resident that is having trouble chewing we have a staff member that sits with them while they are eating. They help the residents arm, if it is a problem chewing and swallowing they are trained to encourage the resident to take small bites and make sure they swallow before taking another bite. We had to cut back on snacks in order to keep the residents under a healthy weight. Snacks are available all throughout the day. We do have resident that lost weight because of other conditions or they are on hospice and pain meds suppress their appetite.

This allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED.

An exit interview was conducted. A copy of the report was provided to administrator James Bird.

SUPERVISOR'S NAME: Lauren Crocker	TELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca Knight	TELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

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