Villa Descanso De Amor

Type of visit: Required - 1 Year

Licensing Program Analysts (LPAs) Paola Guerrero and Andrew Martinez made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPAs met with Facility Administrator Gabriela Thompson and was granted entry to the facility. At the time of the visit there was one (1) staff present, and all five (5) residents were present. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is six (6) current census five (5). LPAs were accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPAs inspected residents' bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPAs observed sufficient furniture and lighting throughout the facility. LPAs measured and observed the water temperatures in the bathrooms to be 110 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. During walkthrough inspection LPAs observed backyard gate to be in disrepair. In addition, LPAs also observed that the side of the house walk way was not cleared and cluttered with wheelchairs, and old matresses LPAs will be issuing deficiencies. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPAs reviewed five (5) resident files for admission agreements, updated physician reports, and needs and services plans. LPAs also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Fire and disaster drills were completed on 12/7/2025 & 1/3/2026. LPAs observed Liability insurance to be current with a renewal date for 2/28/2026. Based on the observations made during today’s visit, two deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Gabriela Thompson.the state’s words, verbatim · CDSS document, Jan 23, 2026

Allegation investigated: Staff did not provide transportation to resident. Staff prevent resident from communicating with social worker.

Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Caregiver Destinee Guzman and explained the purpose of the visit regarding the allegations listed above. First allegation: Staff did not provide transportation to resident. Regarding the allegation Licensing Program Analyst (LPA) conducted an interview with Resident#1 LPA went over the alleged allegation with R#1 and R#1 informed LPA that resident is responsible of their own scheduling of all medical appointments along with scheduling transportation furthermore, R#1 informed LPA that resident is the only one who can schedule and cancel transportation. Resident #1 informed LPA that the facility does not handle resident’s appointments nor does the facility have the ability cancel R#1 transportation. Licensing program analyst LPA conducted an interview with Staff#1 LPA went over the alleged allegation with S#1 and staff denied not providing or canceling R#1 transportation. S#1 informed LPA that R#1 is responsible of scheduling and canceling their own medical appointments along with their transportation. Unsubstantiated Licensing Program Analyst (LPA) conducted an interview with Resident #1 regarding the alleged allegation R#1 informed LPA that R#1 had a scheduled appointment with InnovAge however, R#1 informed LPA that resident canceled and did not attend the appointment. Resident #1 informed LPA that later that day an InnovAge social worker rep arrived at the facility and Resident#1 informed staff that resident declined the visit and did not want to speak with the InnovAge rep. Licensing Program Analyst (LPA) conducted interviews with Staff #1-3 regarding the alleged allegation and all staff denied the allegation and informed LPA that staff informed R#1 about the visit however, R#1 declined and informed staff that R#1 did not want to speak with the InnovAge social worker. Based on corroborating evidence the department has determined that the above allegations are Unsubstantiated, meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Destinee Guzman at the end of the visit.the state’s words, verbatim · CDSS document, Dec 12, 2025 · control 56-AS-20251110101047

Allegation investigated: Licensee does not provide enough food supply to meet resident needs.

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Caregiver Yesenia Castro and explained the purpose of the visit. The investigation consisted of interviews, observations, and review of records. First allegation: Licensee does not provide enough food supply to meet resident needs. Regarding the allegation “Licensee does not provide enough food sully to meet resident needs” LPA conducted interviews with S#2, S#3, and S#4, pertaining to the allegation stated above S#2, S#3, and S#4, informed LPA that on several occasions S#2-4 have purchased food supply out of their own pocket due to food supply shortage. LPA conducted a food supply inspection and observed a minimal of food supply in the refrigerator. LPA conducted an inspection and did not observe facility to have a second refrigerator with overflow food supply. Based on the interviews and evidence gathered the above allegation is Substantiated. Substantiated Substantiated: A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, 87555 (b) (26) General Food Service Requirements, from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided, along with a copy of the appeal rights. to Facility Caregiver Yesenia Castro. Unsubstantiated: meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Yesenia Castro at the end of the visit.the state’s words, verbatim · CDSS document, Jan 24, 2025 · control 56-AS-20250116085916

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555(b)(26) · Plan of correction due date: Jan 27, 2025

87555 General Food Service Requirements.... (b) The following food service requirements shall apply: ...(26) Supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days shall be maintained on the premises. This requirement is not met as evidence by: Based on interviews, and observation, the licensee did not ensure sufficient amont of perishale food supply to be in stock for R#1-5, which poses a potential Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 24, 2025

Plan of correction: Licensee will read over General Food Service Requirement. Licensee will restock refrigerator provide pictures along with grocery receipt to LPA. Licensee will provide an acknowledgement of understanding and email all required documents to LPA on POC date 1/27/2025.

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to this facility to initiate an investigation pertaining to complaint # 56-AS-20250116085916. LPA met with facility caregiver Joaquin Thompson. During today's visit, LPA conducted interviews with residents, staff, obtained and reviewed facility records, LPA Guerrero observed Staff #1 providing care at the facility without criminal background clearance. Facility caregiver informed LPA that criminal clearance was completed however, clearance record was not on file. LPA observed that Staff #1 was not listed under employee roster, and was not listed under guardian. LPA informed S#1 to leave facility. A deficiency will be issued as this pose potential health, safety and personal rights risks to residents in care. A civil penalty of $500 for criminal record clearance was assessed for Staff #1 for working at the facility without criminal background clearance. An exit interview was conducted where this report, LIC809, along with LIC809D, LIC421BG and Appeal Rights were discussed and provided to facility caregiverthe state’s words, verbatim · CDSS document, Jan 24, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 80019(e)(2) · Plan of correction due date: Jan 24, 2025

80019(e)(2) Criminal Record Clearance (e) All individuals subject to a criminal record..licensed facility:(1) Submit a valid mailing..the Department. (A) An individual who holds a..mailing address. (2) Obtain a California clearance...Department or. This requirement is not met as evidenced by: Based on observation, interview and record review, the administrator did not comply with the section cited above in requesting a criminal record clearance for (S#1) which poses an immediate health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Jan 24, 2025

Plan of correction: Administrator will remove (S#1) from the schedule until criminal clearance has been approved. licensee will review the regulation cited and submit a statement of understanding to LPA via email by 01/25/2025.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Administrator Gabriela Thompson and was granted entry to the facility. At the time of the visit there was one (1) staff present, four (4) residents present fifth (5) resident was at the hospital and sixth resident (6) was attending Day Program. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (6). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 110 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed four (4) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Gabriela Thompson.the state’s words, verbatim · CDSS document, Jan 9, 2025

Allegation investigated: Staff did not ensure that medication was inaccesible to residents Staff did not maintain the required temperature in the facility refrigerator

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Caregiver Maria Tess Hartwick and explained the purpose of the visit. The investigation consisted of interviews, observations, and review of records. First allegation: Staff did not ensure that medication was inaccessible to residents. Regarding the allegation “Staff did not ensure that medication was inaccessible to residents” On 9/23/2024 LPA discovered by via photo images that facility was storing medication in a refrigerator that was not maintained locked and medication was accessible to residents in care, which can be a potential health, and safety concern to residents in care. Second allegation: Staff did not maintain the required temperature in the facility refrigerator. Regarding the allegation” Staff did not maintain the required temperature in the facility refrigerator” During the review of records LPA discovered by via photo images that facility refrigerator temperature was set at 6C, Substantiated Unsubstantiated: meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Maria Tess Hartwick at the end of the visit. a temperature that can potentially be harmful. According to title 22 freezers shall be maintained at a temperature of 0 degrees F (-17.7 degrees C), and refrigerators shall maintain a maximum temperature of 40 degrees F (4 degrees C). Based on the evidence gathered during the investigation, the above allegations are Substantiated. Substantiated A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, 87465 Incidental Medical and Dental Care, 87555 General Food Service Requirements from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Maria Tess Hartwick at the end of the visit.the state’s words, verbatim · CDSS document, Dec 16, 2024 · control 56-AS-20240920114542

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(a)(2) · Plan of correction due date: Jan 10, 2025

Incidental Medical and Dental Care.... (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: ....(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement is not met as evidence by: Based on observation, and interviews, licensee did not ensure medications were kept locked and secure for 5 out of 5 residents, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 16, 2024

Plan of correction: licensee has agreed to read over the "Incidental Medical and Dental Care" regulation and provide training to all staff. Licensee will provide a copy of training signed and dated by all staff. Training will be emailed to LPA Guerrero by POC date 1/10/2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87555 · Plan of correction due date: Jan 10, 2025

General Food Service Requirements.... (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner. This requirement is not met as evidence by: Based on observation, and interviews, licensee did not ensure refrigerator was kept at the temperature according to title 22, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Dec 16, 2024

Plan of correction: licensee has agreed to read over the "General Food Service Requirements" regulation and provide training to all staff. Licensee will provide a copy of training signed and dated by all staff. Training will be emailed to LPA Guerrero by POC date 1/10/2025.

The state marks this report as 6 pages; the online copy we transcribed has 5. You can request the full file from the county licensing office.

Allegation investigated: Staff did not allow the resident to leave the facility. Staff did not release the resident's medication.

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Caregiver Asenath Lainez-Munoz and explained the purpose of the visit. The investigation consisted of interviews and review of records. First allegation, Staff did not allow the resident to leave the facility. Regarding the allegation “Staff did not allow resident to leave the facility” LPA conducted interviews with facility Administrator and responsible party, throughout interviews, interviews revealed that Resident#1 Responsible Party informed Facility Administrator regarding Resident #1 moving out of the facility. However, it was reported that Resident #1 Responsible Party did not provide a formal 30-day discharge notice to the Administrator. On 8/22/2024 Resident#1 was prevented from being discharged from the facility. Administrator indicated that responsible party was trying take Resident#1 without paying the facility for care services. Resident was held at the facility for approximately 45-minutes. Second Allegation, Staff did not release the resident’s medication. Substantiated Regarding the allegation “Staff did not release the resident’s medication” During interviews it was revealed that Resident#1 was to be discharged from the facility. On 8/22/2024, Resident#1 medication, was not released and provided to R#1 Responsible Party. Based on the evidence gathered during the investigation, the above allegations are Substantiated. Substantiated: A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, 87468.1 (a)(3)(6)(18) Personal Rights of Residents in All Facilities, from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided, along with a copy of the appeal rights, to Facility Caregiver Asenath Lainez-Munoz.the state’s words, verbatim · CDSS document, Nov 22, 2024 · control 56-AS-20240906161537

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(6)(18) · Plan of correction due date: Dec 20, 2024

87468.1 (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (6) To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night. (18) To move from the facility. This requirement is not met as evidence by: Based on interviews, the Administrator did not follow Personal Rights of Resident and prevented R#1 to leave from the facility, which poses an immediate Health, Safety, or Personal Rights risks to persons in care.the state’s words, verbatim · CDSS document, Nov 22, 2024

Plan of correction: Administrator has agreed to read over Personal Rights of Resident in All Facilities 87468.1(a)(6)(18) regulation and will provide training to all staff. Administrator will provide a copy of the training to LPA. The training will provide signatures and acknowledgement by all staff. Plan of Correction will be emailed to LPA on POC date: 12/20/2024.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(3) · Plan of correction due date: Dec 20, 2024

87468.1 (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidence by: Based on interviews, the Administrator did not follow Personal Rights of Resident and did not release R#1 medication to R#1 Responsible Party, which poses an immediate Health, Safety, or Personal Rights risks to persons in care.the state’s words, verbatim · CDSS document, Nov 22, 2024

Plan of correction: Administrator has agreed to read over Personal Rights of Resident in All Facilities 87468.1(a)(3) regulation and will provide training to all staff. Administrator will provide a copy of the training to LPA. The training will provide signatures and acknowledgement by all staff. Plan of Correction will be emailed to LPA on POC date: 12/20/2024.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Paola Guerrero made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Administrator Joaquin Thompson and was granted entry to the facility. At the time of the visit there was two (2) staff present, and six (6) residents present. The facility is a six (6) bedroom, three (3), bathroom home, with a kitchen/dining area, living room, un attached garage. The facility is a Residential Care Facility for Elderly (RCFE) Licensed capacity is (6) current census (6). LPA was accompanied by Facility Administrator, to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA inspected resident’s bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be 105 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside medication closet inaccessible to residents in care. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Non-perishable and perishable food supply is sufficient for number of residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. All staff members working in the facility have criminal record clearance through the department. Record Review: LPA reviewed six (6) resident files for admission agreements, updated physician reports, and needs and services plans. LPA also reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff members. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Administrator Joaquin Thompson.the state’s words, verbatim · CDSS document, Jan 8, 2024

Allegation investigated: Facility did not issue a refund to a resident in care.

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegation listed above. LPA met with Facility Administrator Joaquin Thompson and explained the purpose of the visit. The investigation consisted of interview and review of records. First allegation, Facility did not issue a refund to a resident in care. During interview with administrator regarding resident’s refund Administrator stated that the refund pertaining to Resident #1 (R#1) was still pending and has not been issued because of financial reasons. On 11/7/2023 family indicated that Resident #1 was admitted to the facility on 6/30/2023 and Resident #1 vacated the facility on 7/11/2023. Family has stated that they have yet to receive any refund which was indicated by the facility. Based on the evidence gathered during the investigation, the above allegations are Substantiated. Substantiated Substantiated A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Title 22 regulations, Admission Agreements 87507 a from division 6, chapter, article 6, is being cited on the attached LIC 9099 D. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided, along with a copy of the appeal rights. to Facility Administrator Joaquin Thompson at the end of the visit.the state’s words, verbatim · CDSS document, Nov 7, 2023 · control 56-AS-20231101131317

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87507a · Plan of correction due date: Dec 1, 2023

87507 a. A refund of at least 80 percent of the preadmission fee in excess of $500 shall be provided if the applicant does not enter the facility after a preadmission appraisal is conducted, or the resident leaves the facility for any reason during the first month of residency. This requirement is not met as evidence by: Based on obervation, interviews and record review, the licensee did not ensure admission agreement "Refund" was followed, which poses an immediate Health, Safety, or Personal Rights risk to persons in carethe state’s words, verbatim · CDSS document, Nov 7, 2023

Plan of correction: Administrator has agreed to read over the entire Admissions Agreement regulation and provide a signed and written acknowledgement of understanding regarding refund procedures. Administrator will email document to assigned LPA by 12/1/2023

Type of visit: Case Management - Deficiencies

Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to the facility for complaint control number 18-AS-20220207165851. During the complaint visit, LPA Rico completed a case management visit to cite for a deficiency found during the complaint record review. During record review, Licensee did not provide a completed Physician Report LIC 602 for R5. The LIC 602 provided to LPA was incomplete. Licensee must provide a completed Physician Report on file. During today’s visit, one (1) deficiency were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report was discussed through the phone to Gabriela Thompson and provided to Sharee Glisson , along with a copy of the appeal rights.the state’s words, verbatim · CDSS document, Oct 27, 2023

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87458(a) · Plan of correction due date: Nov 3, 2023

87458(a) Medical Assessment (a)Prior to a person's acceptance as a resident, .. The licensee shall be permitted to use the form LIC 602 (Rev. 9/89), Physician's Report, to obtain the medical assessment.This requirement is not met as evidenced Based on recrod review the licensee did not comply with the section cited above by not having R5 physician reports, which poses a potiential health and safety risk to persons in carethe state’s words, verbatim · CDSS document, Oct 27, 2023

Plan of correction: Licensee has agreed to send LPA Physician's Report for R5. Completed and updated by Physician. POC due date 11/3/2023

Allegation investigated: Staff handled resident in an aggressive manner resulting in injury. Facility did not seek medical attention for resident. Staff yelled at resident. Facility did not allow resident to have visitors.

Licensing Program Analyst (LPA) Paola Guerrero conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Facility Administrator Joaquin Thompson and explained the purpose of the visit. The investigation consisted of interviews and a review of records. First allegation, Staff handled resident in an aggressive manner resulting in injury. During interview with Staff #1 (S1) and Staff #2 (S2) both denied handling Resident #1 in a rough manner or injuring Resident #1 (R1). LPA asked Staff #1 (S1) and Staff #2 (S2) if they have witnessed staff handling Resident #1 (R1) in a rough manner Staff #1 (S1) and Staff #2 (S2) stated “No”. LPA interviewed Resident # 2, Resident #3, Resident #4, and Resident #5 and all denied witnessing Resident # 1 (R1) being handled in a rough manner by staff. LPA asked Resident 2-5 if staff has handled them in a rough manner all stated “No” Resident #3 (R3) and Resident #4 (R4) stated that facility staff is kind and attend to their needs. Second allegation, Facility did not seek medical attention for resident. Unsubstantiated During interview with Staff #1 (S1), and Staff #2 (S2), both stated that facility has no reports, incidents, or physical observations indicating that Resident #1 needed medical attention. LPA conducted a record review of Resident #1 records and LPA did not find any Special Incident Reports (SIR's) pertaining to Resident #1. Third allegation, Staff yelled at resident. During interviews with Staff #1 (S1) and Staff #2 (S2) both staff denied yelling at Resident #1. LPA conducted interviews with Resident # 2, Resident #3, Resident #4, and Resident #5. All residents denied being yelled at by staff or witnessing staff yell at Resident # 1. Fourth allegation, Facility did not allow resident to have visitors. LPA conducted a record review upon record review LPA observed a conversation exchange via text message between staff and responsible party in which staff indicated to Resident #1 responsible party that visitations were not being denied to family member[s] however, visitations were to be held outside facilities front porch. Based on the evidence obtained during the course of the investigation, LPA has determined that the above allegations are Unsubstantiated. Unsubstantiated; meaning that 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. An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Administrator Joaquin Thompson at the end of the visit.the state’s words, verbatim · CDSS document, Oct 11, 2023 · control 56-AS-20230711091759