Commonwealth Royale Guest Home

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Administrator Anna Rempel and explained the reason for the visit. The Investigation consisted of the following: LPA conducted interviews with Administrator Anna Rempel, Staff 1-4 (S1-4) and Residents 1-8 (R1-8). LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1-8's facility files, collected copies of documents pertinent to the complaint investigation. (See LIC9099C for continuation) Unsubstantiated— CDSS inspection report, February 8, 2024 · control 28-AS-20240202135715

Licensing Program Analyst (LPA) V. Maldonado made an unannounced complaint visit at the facility for the purpose of investigating the above-mentiond allegations. LPA Maldonado met with staff, Gary Kitt, and Administrator, Ana Rempel, and explained the purpose for the visit. During today's visit, LPA Maldonado obtained a copy of the resident and staff roster, and the following documents for Resident# 1 (R1): Facesheet, Physician's Report, and Resident Personal Property and Valuables sheet (LIC621). LPA also conducted interviews with Residents# 2-9 (R2-R9), and Staff# 1-6 (S1-S6). LPA was unable to interview R1 due to R1 out in the community during the visit. The investigation revealed the following: Regarding allegation: Staff did not safeguard resident's money. It is alleged that a S3 stole $600 on 1/28/24 and $1,000 on 1/29/24 from R1's room, totaling $1,600. LPA was unable to interview R1 to obtain additional information. (Report continued on LIC9099-C...) UnsubstantiatedRead the full finding— CDSS inspection report, February 8, 2024 · control 28-AS-20240131085828

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegations. LPA met with Administrator Anna Rempel and explained the reason for the visit. The Investigation consisted of the following: LPA conducted an interview with Administrator Anna Rempel and obtained copies of Staff and Resident Rosters. LPA reviewed Administrator Rempel facility file and collected a current copy of Residential Care for the Elderly Administrator Certificate. (See LIC9099C for continuation) Unsubstantiated— CDSS inspection report, February 1, 2024 · control 28-AS-20240124140408

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegations. LPA met with Administrator Anna Rempel and explained the reason for the visit. The Investigation consisted of the following: LPA conducted interviews with Administrator Anna Rempel, Staff 1-4 (S1-4) and Residents 1-8 (R1-8). LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1-8's facility files, collected copies of documents pertinent to the complaint investigation, and RNS Pest Elimation Service receipts. LPA also conducted a tour of facility which included observations of two floors and inspected a total of 5 resident bedrooms (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, February 1, 2024 · control 28-AS-20240126125649

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegations. LPA met with Assistant Administrator Anna Rempel and explained the reason for the visit. The Investigation consisted of the following: LPA conducted interviews with Assistant Administrator Anna Rempel, Staff 1-3 (S1-3) and Residents 1-8 (R1-8). LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1-8's facility files, R1-8's medications and Medication Administration Records (MARs), S1-3 files and collected copies of R1-8 MARs for December 2023 and January 2024 and other documents pertinent to the complaint investigation. LPA additionally conducted a tour of the facility including medication room. (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, January 19, 2024 · control 28-AS-20240116090448

Licensing Program Analyst (LPA) V. Maldonado made an unannounced initial complaint visit at the facility for the purpose of investigating the above-mentioned allegations. LPA Maldonado met with Administrator, Gary Kitt, and explained the purpose for the visit. During today's visit, LPA Maldonado obtained a copy of the resident roster, staff roster, and the facility Theft and Loss Policy. LPA Maldonado also obtained the following records for Resident# 1 (R1): Facesheet, Physician's Report, and Resident Personal Property and Valuables (LIC621), and conducted interviews with Staff# 1-3 (S1-S3) and attempted interviews with Residents# 1-8 (R1-R8). The investigation revealed the following: Regarding allegation: Staff stole resident's belonging. It is alleged that upon 48 hours of moving into the facility, R1 was robbed of coat hangers, a coat rack, a leather jacket, and personal memorabilia by an unknown staff member. (3) of (3) Staff interviewed denied the allegation. (Report continued onRead the full finding— CDSS inspection report, December 28, 2023 · control 28-AS-20231221163709

Licensing Program Analyst (LPA) Alma Gonzalez conducted a subsequent complaint visit to deliver investigation findings for the above stated allegation. LPA met with Administrator Gary Kitt and Assistant Administrator Anna Rempel and explained the reason for the visit. The investigation consisted of: During the initial visit conducted on 01/27/23, LPA Mora collected copies of resident and staff rosters and copies of documents relevant to the investigation. LPA Mora conducted a tour of the facility and common areas. LPA Mora observed a sufficient supply of perishable and non-perishable foods. LPA Mora observed the residents to identify any signs of neglect, abuse, or other immediate health and safety threats. LPA Mora did not observe any immediate health and/or safety concerns at the time of the visit. On 02/16/23, Investigator Dennis Seng interviewed R1-2, and Staff 1 (S1). (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, October 17, 2023 · control 28-AS-20230126113924

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Assistant Administrator Anna Rempel and explained the reason for the visit. The investigation consisted of: LPA conducted interviews with Assistant Administrator Anna Rempel, Staff 1-3 (S1-3) and Residents 1-8 (R1-8). R9 was not interviewed as resident was not at the facility at the time of the visit. LPA collected copies of Staff and Resident Rosters. LPA reviewed R8-9's facility files and collected copies of documents relevant to the investigation. LPA also collected a copy of Unusual Incident/ Injury Report dated 08/26/23. (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, September 7, 2023 · control 28-AS-20230901134314

Licensing Program Analyst (LPA) Alma Gonzalez conducted a subsequent complaint visit to deliver investigation findings for the above stated allegations. LPA met with Administrator Gary Kitt and explained the reason for the visit. The investigation consisted of: During the initial visit conducted on 05/30/23, LPA conducted interviews with Administrator Anna Rempel. LPA collected copies of Staff and Resident Rosters. LPA also conducted a tour of the facility inside and out including included lobby, dining room, outside patio areas, kitchen and two designated smoking areas. On 07/27/23, LPA collected copies of Staff and Resident Roster and interviewed Staff 1-3 (S1-3) and Residents 1-9 (R1-9). LPA additionally requested a copy of facility menu and conducted a tour of facility including kitchen, food storage, and outside designated smoking area. (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, July 27, 2023 · control 28-AS-20230524120512

Licensing Program Analyst (LPA) Alma Gonzalez conducted a subsequent complaint visit to deliver investigation findings for the above stated allegations. LPA met with Administrator Gary Kitt and Assistant Administrator Anna Rempel and explained the reason for the visit. The investigation consisted of: During the initial visit conducted on 8/30/21, LPA Gonzalez collected copies of Staff and Resident rosters, reviewed R1's file, and collected copies of documents pertinent to the investigation. LPA also conducted interviews with Administrator Gary Kitt, Assistant Administrator Anna Rempel and R1's doctor by telephone. LPA also conducted a tour of entire facility inside and out with Assistant Administrator Anna Rempel and LPA did not observe any immediate Health & Safety concerns during the visit. On 02/21/23, LPA mailed/ faxed an Investigative Subpoena Duces Tecum to PIH Health Good Samaritan Hospital requesting medical records regarding R1. On 02/27/23, LPA received (See LIC9099C for contRead the full finding— CDSS inspection report, July 17, 2023 · control 28-AS-20210827134530

Licensing Program Analyst (LPA) David Sicairos conducted an unannounced complaint visit regarding the above stated allegation. LPA met with Administrator Ana Rempel and explained the reason for the visit. The investigation consisted of the following: during the initial Televisit conducted on 05/07/21, LPA interviewed the Administrator and obtained copies from Resident #1 (R1) file such as: ID & Emergency Sheet, Physician's Report, Resident Appraisal, and Incident Report. During today's visit, LPA obtained copies of Resident & Staff Rosters and interviewed Staff #1 - Staff#3 and Resident #2 - Resident#8. Resident #1 (R1) was not interviewed as R1 is no longer a resident of the facility. The investigation revealed the following: in regards to the allegations "facility is not ensuring that resident is eating" and "facility is not ensuring that resident is drinking fluids", it is alleged that R1 has not been eating or drinking water at the facility and has been self-neglecting. R1 moved inRead the full finding— CDSS inspection report, August 12, 2022 · control 28-AS-20210504154700

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Administrator Anna Rempel and explained the reason for the visit. The investigation consisted of: LPA conducted interviews with Administrator Anna Rempel, Staff 1-2 (S1-2) and Residents 1-8 (R1-8). LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1's facility file and collected copies of the following documents: Identification and Emergency Information LIC601 dated 8/4/21, Preplacement Appraisal Information LIC 603 dated 8/2/21, Resident Appraisal LIC603A dated 8/4/21, Client/ Resident Personal Property and Valuables, Facility Note regarding R1, Telecare Transportation Request dated 3/3/22, Note signed by R1's Family Member (R1 FM) regarding personal belongings dated 3/26/22, and Physician's Report For Residential Care Facilities for the Elderly LIC 602A dated 10/8/21. (See LIC9099C for continuation) UnsuRead the full finding— CDSS inspection report, April 11, 2022 · control 28-AS-20220404150645

Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced initial complaint visit at the facility and met with Administrator Anna Rempel and explained the purpose for todays visit. The investigation consisted of the following: LPA conducted an interviews with the Administrator, residents, and staff, and also requested a copy of the staff and resident roster. Regarding allegaton: Facility not following COVID-19 guidelines. During the interview with the Administrator Anna Rempel, she informed the LPA that on 03/10/22 the Long Term Care Ombudsman(LTCO) arrived to the facility and did not check in with the staff to be screened prior to conducting a visit in the facility. The Administrator also informed the LPA that she saw the LTCO in dining room which is by the PPE station and facility entrance and asked if they needed any assistance. LPA Wesley observed the sign in station with hand santitizer at the entrance of the facility and the temperature check is taken at the AdministrRead the full finding— CDSS inspection report, March 29, 2022 · control 28-AS-20220323161630

Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Administrator Gary Kitt and Assistant Administrator Anna Rempel and explained the reason for the visit. The investigation consisted of: LPA conducted an interview with Administrator Gary Kitt and Assistant Administrator Anna Rempel. LPA conducted interviews with Staff 1-3 (S1-3) and Residents 1-6 (R1-6). LPA obtained copies of Staff and Resident Rosters. LPA also conducted a tour of facility which included observations of common areas, lobby, dining room, kitchen and random resident rooms. (See LIC9099C for continuation) UnsubstantiatedRead the full finding— CDSS inspection report, February 3, 2022 · control 28-AS-20220128143136