Aegis Living Corte Madera

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegation listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegation and met with Rabah Sbaitan, General Manager. Staff did not ensure medication was dispensed as prescribed – Complainant alleges resident (R1)’s nebulizer was broken making staff unable to provide liquid albuterol treatment and when the resident was questioned, they stated they didn’t remember because it had been so long. Per review of Medication Administration Records (MAR) and interviews conducted indicated, resident was given nebulizer treatment as prescribed. Per interview with staff (S1) they experienced functional issues with the nebulizer but determined this nebulizer functioned differently than others they had used. S1 was able to figure out how nebulizer worked and provided treatment per doctors’ orders. No further issues noted. Continue on LIC9099-C UnsubstantiatedRead the full finding— CDSS inspection report, May 9, 2024 · control 21-AS-20240422101726

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegation listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegation and met with Rabah Sbaitan, General Manager. Facility did not report incident to responsible party timely – Complainant alleges resident (R1) fell the morning of 12/6/2023 and the facility did not contact R1’s family for over 24 hrs regarding the incident. LPA’s interview with staff (S1) revealed once they were informed by staff, S1 called R1’s responsible party. (LPA observed personal cell phone of wellness nurse showing 1 call made to responsible party on 12/6/23). S1 also indicated they could not leave a message as the phone stated, "voice mail was full and could not accept message". Emergency Medical Services (EMS) report obtained revealed 911 was called at 11:14am on 12/6/2023 and paramedics arrived shorty after. Continue on LIC9099C UnsubstantiatedRead the full finding— CDSS inspection report, February 12, 2024 · control 21-AS-20231208162004

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegation listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegation and met with Rabah Sbaitan, General Manager. Facility staff did not safeguard resident’s personal belongings – Complainant alleges resident (R1)’s gold necklace with pendant went missing after hospital visit 6/2022 and reported to general manager, then in 9/2023 R1’s watch went missing. R1s’ Personal Property Inventory documents obtained from move in singed and dated by POA 6/13/2014 indicates “Items to be inventoried will be listed on form LIC 621, signed, and dated by all parties. A copy of the inventories will be provided to all parties. If no inventory is desired, the resident or responsible party will write “waived” on the LIC 621 form, and sign & date it. Waived has been written on form. Continue 9099C UnsubstantiatedRead the full finding— CDSS inspection report, February 12, 2024 · control 21-AS-20231114084622

Licensing Program Analyst Leibert arrives unannounced for the purpose of delivering findings on this complaint. It has been alleged that staff neglect resulted in R1's sepsis condition. This investigation indicates that resident ( R1) was hospitalized on 9/12/23 for symptoms of rhinovirus infection; R1 was discharged on 9/16/23 with diagnosis that included Sepsis; R1 reported upon admission to be feeling in R1's "general state of health until earlier the same day;" Staff physician observed R1 mid-day 9/12/23 and reports" ( R1) did not have any respiratory distress evident;" Private caregiver for R1 who provides care twice a week has stated that caregiver has no knowledge of any neglect of R1 by staff; Facility caregivers who showered and assisted R1 the morning of 9/12/23 report not observing R1 exhibiting any unusual symptoms that would require intervention. This investigation included review of documents, including medical records for R1, as well as interviews with staff; relatives,Read the full finding— CDSS inspection report, November 14, 2023 · control 21-AS-20230914082504

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegations listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegations and met with Administrator, Nithi Narasappa. During complaint investigation LPA conducted interviews with 4 staff and outside individual, made observations at facility on 8/15/2023 & 10/26/2023 and reviewed records. Staff are locking residents in their rooms- Complainant alleges another individual informed, residents in the memory care are locked in their rooms any time they are in their rooms and when inquired, response was, locking memory care residents is legal as this keeps residents from wandering out. LPA observations of facilities memory care unit on 10/26/2023 revealed five of ten apartment doors checked were locked, with residents in the five rooms. Continue on LIC9099-C UnsubstantiatedRead the full finding— CDSS inspection report, November 13, 2023 · control 21-AS-20230814125522

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegation listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegations. LPA met with Nithi Narasappa, Director of Operations/Interim Administrator. During complaint investigation LPA conducted interviews with 3 staff and 3 residents, made observations at facility on 8/15/2023 & 9/7/2023 and reviewed records. Personal Rights – Complainant alleges staff does not provide assistance to resident when needed. Reporting Party (RP) stated when R1 needs assistance S1 does not pay attention to R1. No other details provided to RP from R1. Review of staff records confirmed training per regulation for S1. S1 is a long-term staff and interviews with S2 and Administrator did not reveal staff does not provide assistance to resident when needed. Continue on LIC9099-C UnsubstantiatedRead the full finding— CDSS inspection report, October 26, 2023 · control 21-AS-20230809124148

Licensing Program Analyst (LPA) Hansen arrived unannounced at the facility to deliver findings regarding the above allegations. LPA met with Business Office Manager Ruksshana Shah, Administrator, Donald Stamets was out of the facility. Staff mismanaging residents’ medications – Complaint alleges staff did not ensure residents medications were administered or ingested properly. LPA obtained records indicating medication records to be in order. Medication Administration Record (MAR) for February and March of 2023 show resident refused medications, 9 times in February and 19 times in March. Based on interviews with Staff (S1-S2) indicated they were aware of R1’s behavior and issue with taking medication by cheeking the medication and later spitting out unbeknownst to staff. When R1 did cheek the medication staff would sit with R1 and wait and talk to R1 for a while until R1 either spit it out or would swallow it. Sometimes R1 would choke it back up later and staff would find it. While conRead the full finding— CDSS inspection report, August 3, 2023 · control 21-AS-20230406084732

Licensing Program Analyst (LPA) Hansen arrived unannounced at the facility to deliver findings regarding the above allegations. LPA met with Business Office Manager Ruksshana Shah, Administrator, Donald Stamets was out of the facility. During investigation LPA reviewed documents obtained including Police Report and conducted interviews with resident (R1) and staff regarding allegation. Complaint alleges that resident was inappropriately touched by staff. Interview with R1 revealed that resident was unable to confirm alleged event due to confusion. R1 was sent out on 6/10/2023 to emergency room due to observed vaginal bleeding. It was determined at the hospital R1 had a urinary track infection. Additional information obtained during investigation does not support a violation occurred. Police report obtained indicates no further action and is closed. UnsubstantiatedRead the full finding— CDSS inspection report, August 3, 2023 · control 21-AS-20230615084005

Licensing Program Analyst (LPA) Hansen arrived unannounced at the facility to deliver findings regarding the above allegations. LPA met with Director of Operations, Nithi Narasappa. During the investigation, the Department conducted interviews, reviewed documents, and made observations. Staff do not answer calls buttons timely – Complaint alleges that call buttons and call pendant’s are pressed and staff do not respond for over 40 minutes or not at all. Per interview and email received 4/10/2023 with Administrator, designated timeframe of when call buttons are to be responded to by staff is a 10-minute standard. SMARTcare report obtained from 3/1/2023-3/20/2023 reflect at least six hundred and fifty-four response times between 10-30 minutes, and at least 66 response times between 30-60 minutes, and at least 43 response times that were more than 60 minutes or never responded to. Based on LPA’s interviews conducted and a review of call log records, the preponderance of evidence standardRead the full finding— CDSS inspection report, July 6, 2023 · control 21-AS-20230309085241

Licensing Program Analyst (LPA) Hansen arrived unannounced at the facility to deliver findings regarding the above allegations. LPA met with Director of Operations, Nithi Narasappa. During the investigation, the Department conducted interviews, reviewed documents, and made observations. Facility kitchen is dirty - On 6/15/2023 & 6/20/2023 LPA conducted unannounced visits to facility. LPA toured the kitchen and observed meals being prepared and the kitchen, floors, countertops clean (see Pics LIC812). LPA was informed by reporting party during interview, allegation was from a third party and reporting party was not sure of validity. Based on observations & interviews there is insufficient information to prove or disprove the allegation listed above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated. UnsubstantiatedRead the full finding— CDSS inspection report, July 6, 2023 · control 21-AS-20230607095941

Licensing Program Analyst (LPA) Hansen arrived unannounced on 04/11/2023 to deliver findings regarding the above allegation. LPA met with Executive Director, Donald Stamets. During the investigation, the Department conducted interviews, reviewed documents, and made observations. There was an allegation that Facility staff inappropriately touched a resident while in care. Reporting Party (RP) reported to the Department on 3/1/2023 that Resident (R1) had been inappropriately touched by Staff (S1) resulting in a bruise on left breast and R1 express they feel unsafe around S1. During the investigation, R1 gave inconsistent statements to the investigator and other parties when questioned about the alleged abuse. Inconsistent information involving the time, location and details of the alleged abuse and abuser. The department conducted subsequent interviews with Residents, Staff, Police Department and Outside Parties which concluded that there wasn’t enough corroborating evidence to support tRead the full finding— CDSS inspection report, April 11, 2023 · control 21-AS-20230301161214

Licensing program Analyst (LPA) Hansen arrived unannounced to deliver findings regarding the above complaint allegation and met with Administrator, Donald Stamets. Staff do not respond timely to the resident’s alerts – Complaint alleges that staff are not responding to pendants being pushed, in a timely manner due to lack of staffing. Per interview and email received 4/10/2023 with Administrator, designated timeframe of when call buttons are to be responded to by staff is a 10-minute standard. SMARTcare report obtained from 1/23/2023-2/3/2023 reflect at least three hundred and one response times between 10-30 minutes, and at least 37 response times between 30-60 minutes. Based on LPA’s interviews conducted and a review of call log records, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard haRead the full finding— CDSS inspection report, April 11, 2023 · control 21-AS-20230202120218

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegations listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegations. LPA met with Director of Operations, Nithi Narasappa as Administrator Donald Stamets out. Staff is not adequately trained – Complainant alleges staff is not properly trained. The LPA reviewed information provided by the reporting party. The LPA reviewed resident records (R1), including care plan, medical records, incidents, medication records, and progress notes. Per interviews and records reviewed the nebulizer at time staff was attempting to use appeared to be not functioning correctly. Staff attempted to contact RP and as a result contacted 911. The nebulizer was stored in resident’s room and interviews revealed, may have been tampered with. Per Fire Department report resident was assisted with fixing nebulizer. LPA reviewed staff training records. The LPA conducted inteRead the full finding— CDSS inspection report, February 24, 2023 · control 21-AS-20221115134740

Licensing Program Analyst (LPA) Hansen conducted a complaint investigation regarding the allegations listed above. LPA arrived unannounced on this day for the purpose of delivering findings of the above allegations. LPA met with Administrator, Donald Stamets. Call button in residents room not functioning - Complainant alleges call button in R1’s room not functioning. From LPA’s observation of alarm test and bathroom call button pushed at 2:24pm on 7/21/2022, facility care staff 1 minute later knocked on door, opened, and came in. In addition, a second care staff came in within 15 seconds after 1st staff to check on resident. LPA observed staff turn off silent alarm located in the bathroom. LPA obtained copy of R1’s alarm history from 6/21/22 to 6/30/22 albeit Administrator has informed there is a glitch in the system, logging is absent from 6/21/22 through 6/27/22. Facility learned that call pendant that resident R1 was wearing on the morning of 6/25/2022, when R1 fell on hallway floorRead the full finding— CDSS inspection report, September 20, 2022 · control 21-AS-20220623113941

Licensing Program Analyst (LPA) Hansen made an unannounced subsequent visit to the facility. The purpose of this visit is to deliver findings for the above allegation. LPA met with Administrator Donald Stamets. Complaint alleged that facility failed to administer R1’s medication per physicians orders. Per reporting party, R1 notified staff at facility about shortness of breath/asthma but was not given medication and called 911. Record review of physician report (dated 4/2/22) revealed R1 has asthma and requires assistance administering prescription medications and PRN (as needed) medications. Primary care physician orders/email of (5/31/2022) show R1 has daily scheduled preventative medications and also PRN medications if R1 feels wheezy or short of breath. Interviews, nursing notes, and document from Administrator revealed on 5/26/2022 at approximately 7:28pm R1 called facility front desk stating, “having an asthma attack”. Nurse responded, assessed, and informed R1 medication would bRead the full finding— CDSS inspection report, June 14, 2022 · control 21-AS-20220527104945