Cogir Of San Rafael

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff handled resident roughly causing resident to fall Facility did not seek timely medical Facility did not report abuse to responsible party

At approximately 11:50AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Complaint Investigation regarding the above allegations and met with Business Office Director, Ditter Vasquez. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There are allegations that "Staff handled resident roughly causing resident to fall, Facility did not seek timely medical, and Facility did not report abuse to responsible party." Complainant alleged the following: Staff Member 1 (S1) roughly handled Resident 1 (R1) while providing care causing R1 to fall and hit their head, facility did not seek timely medical for R1 after the fall, and facility did not report abuse to R1's responsible party. Continued on LIC9099C Substantiatedthe state’s words, verbatim · CDSS document, Jun 5, 2025 · control 21-AS-20250401143349

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not assist resident with self-administration of medication Personal Rights

At approximately 1:50PM, Licensing Program Analyst (LPA) Felias arrived unannounced to deliver findings for this Complaint Investigation regarding the above allegations and met with Executive Director, Kimberly Humphrey and Business Office Manager, Ditter Vazquez. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. The following allegations were investigated, “Staff did not assist in self-administration of medication, and Personal Rights.” “Staff did not assist in self-administration of medication” – Complainant alleged that facility staff refused to administer Resident 1 (R1’s) morphine medication when they were in extreme pain on 11/03/2025 and 11/04/2025. Complainant also alleged that facility staff forced R1 to take their morphine when they were dying even though R1’s family asked facility staff to not administer it. Continued on LIC9099 Unsubstantiatedthe state’s words, verbatim · CDSS document, Mar 28, 2025 · control 21-AS-20241108085658

Allegation investigated: Staff do not provide residents with adequate food service Staff do not prepare meals in a sanitary manner Staff do not use soap to wash facility dishes Staff do not seek medical attention for residents in a timely manner

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. Through interviews, document reviews and unannounced site visits, the following determinations are made: LPA Leibert made unannounced inspections of the kitchen and food service on 2/4/25, 2/27/25, and 3/13/25; Inspections found the dishwasher to be operative with adequate detergent on site; Interviewed staff deny using vinegar to clean dishes; Staff were observed following appropriate sanitation protocols; Facility menus comply with Title Twenty-Two regulations and inspections found food on hand to fulfill the menu requirements; Adequate beverages, snacks, and deserts were observed to be stocked; 2 out of 10 family members asked to comment on food service report satisfaction with the food served; Facility Care Notes for Resident (R1) indicate R1 was sent out on 11/30/24 when observed to be pale with breathing problems; R1 was noted to be at Baseline prior on 11/29; R1 remainthe state’s words, verbatim · CDSS document, Mar 25, 2025 · control 21-AS-20250127130724

Allegation investigated: Facility's emergency call system was in disrepair

At approximately 9:05AM, Licensing Program Analyst (LPA) Felias arrived unannounced to initiate a Complaint Investigation regarding the above allegations and met with met with Executive Director/Administrator, Kimberly Humphrey. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There is an allegation of "Facility's emergency call system was in disrepair.” Complainant alleged that there were many occasions that the facility's pull cords were not functional and that facility staff were not receiving the calls on their pagers. Interview conducted with Executive Director stated that the facility's call system was not working approximately four weeks ago and was fully repaired this past Monday, 03/10/2025. Per Executive Director, Continued on LIC9099C Substantiatedthe state’s words, verbatim · CDSS document, Mar 14, 2025 · control 21-AS-20250306172541

Allegation investigated: Reporting Requirements

At approximately 10:20AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Complaint Investigation regarding the above allegation and met with met with Business Office Director, Ditter Vasquez. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There is an allegation of "Reporting Requirements.” Complainant alleged that facility did not submit a report to the Department regarding potential abuse. Further information provided to LPA indicated that the incident involved a medication error. Review of documents showed that the Department received a report involving the identified incident. Continued on LIC9099C Unfoundedthe state’s words, verbatim · CDSS document, Feb 26, 2025 · control 21-AS-20250113133346

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff is not following doctor's orders for resident's wound care Staff is overcharging resident in care

At approximately 11:30AM, Licensing Program Analyst (LPA) Felias arrived unannounced to deliver findings for this Complaint Investigation regarding the above allegations and met with Regional Executive Director, Davina Barker. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There is an allegation that “Staff is overcharging resident in care.” Complainant stated that Facility billed Resident 1 (R1) for a compression sleeve that R1 does not use or need. Complainant also alleged that the facility refused entry to the home health agency that was ordered to provide wound care and instead provided the wound care in the facility costing more money and more levels of care for the resident. Review of facility documents show that R1’s Physician ordered for them to have a compression leg machine and compression stockings dated 06/03/2021 and 05/17/2023. Continued on LIC9099C Unsubstantiatedthe state’s words, verbatim · CDSS document, Aug 21, 2024 · control 21-AS-20240514163205

Allegation investigated: Facility did not provide representative with an updated care plan with explanation of care charges Facility does not respond to representative timely

At approximately 12:50PM, Licensing Program Analysts (LPAs) Felias and Loera arrived unannounced to deliver findings for this Complaint Investigation regarding the above allegations and met with Regional Executive Director, Davina Barker, and Health and Wellness Director, Victoria Mozaffari. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There is an allegation that “Facility did not provide representative with an updated care plan with explanation of care charges.” Complainant stated that R1’s Responsible Party was being charged $100 per day for R1 to receive wound care treatment and that R1’s care increased from a Level 5 to a Level 9 with no explanation. Interview conducted with Facility’s Health and Wellness Director (HWD) stated that R1 was put on a Temporary Service Plan (TSP) in February 2024 due to increased care needs. Continued on LIC9099C Substantiatedthe state’s words, verbatim · CDSS document, Aug 8, 2024 · control 21-AS-20240424094747

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Staff did not provide responsible party with 30 day eviction notice.

At approximately 9:10AM, Licensing Program Analyst (LPA) Felias arrived unannounced to continue a Complaint Investigation regarding the above allegation and met with Executive Director/Administrator, Susan Edwards. During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. There is an allegation that “Staff did not provide responsible party with 30 day eviction notice.” Complainant alleged that Resident 1 (R1) and their designated representatives conducted a meeting with the facility where it was discussed that R1 be relocated or discharged from the facility. Complainant stated that the facility did not provide R1 and their designated representatives with any documentation and did not use the word “eviction” and only used terms like “decision to relocate” or “discharge.” Complainant stated that facility did not provide R1 and their designated representatives with a written eviction notice. Continued on LIC9099Cthe state’s words, verbatim · CDSS document, May 2, 2024 · control 21-AS-20240308152416

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Allegation investigated: Resident has been issued an unlawful eviction

At approximately 1:00PM, Licensing Program Analyst (LPA) Felias arrived unannounced to initiate a Complaint Investigation regarding the above allegation and met with Executive Director/Administrator, Susan Edwards. During the course of the Investigation, LPA requested and reviewed documents, conducted interviews, and made observations. There is an allegation of an Unlawful Eviction. Reporting Party stated that R1 and their Responsible Party had a verbal agreement with the former company of the facility, Sunrise Senior Living, where they were allowed to pay their rent one month late. This verbal agreement was continued when the facility was taken over by Cogir Senior Living in July 2021. Record Review showed that there is no written agreement between Cogir Senior Living Management and R1 and their Responsible Party agreeing to continuing this verbal agreement. Continued on LIC9099C Unfoundedthe state’s words, verbatim · CDSS document, Feb 14, 2024 · control 21-AS-20240205134542

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.

Report on file with the state — no findings text was published for this visit. The complete document is on the state’s site.