Inspection Reports for
CityView

The complaint alleged that staff caused injuries to Resident #1 by causing a fall from a wheelchair resulting in head, knee, and fracture injuries. Interviews with five staff members, ten residents, and two witnesses did not corroborate the claim of staff negligence. Records showed the resident was not assessed as a fall risk and was on medications increasing fall risk. The incident area showed no safety issues. The allegation was unsubstantiated due to insufficient evidence.

The investigation included interviews with staff, residents, and witnesses, review of records, and facility observation. The Department found insufficient evidence to support the allegation that staff negligence caused the resident's fall and injuries. The allegation was determined to be unsubstantiated and no deficiencies were cited.

The complaint alleged the presence of pests including roaches in multiple areas of the facility and that the facility smelled like poison. Interviews revealed mixed reports of past sightings of roaches by some staff and residents, but ongoing pest control services were documented. The allegation was unsubstantiated.

The investigation included interviews with staff and residents, review of pest control records, and a facility tour. No pests or pest control odors were observed during the visit. The allegation was found to be unsubstantiated due to insufficient evidence.

The complaint alleged that staff did not provide medication assistance to residents in a timely manner, resulting in residents missing meals. The investigation included interviews with residents and staff, review of medication administration records and staff training. The allegation was found unsubstantiated.

The investigation found that six out of eight residents and all seven staff interviewed did not agree with the allegation, and record reviews showed all seven residents received their medications as scheduled. Staff training records were also compliant. Therefore, the allegation was unsubstantiated due to lack of preponderance of evidence.

The complaint investigation was triggered by allegations that staff did not ensure resident's personal care hygiene needs were met, did not provide clean bedding, and did not safeguard resident's personal possessions. After interviews and records review, the allegations were determined to be unsubstantiated due to lack of preponderance of evidence.

The investigation included interviews with staff, residents, and review of records. All three allegations—failure to meet personal care hygiene needs, failure to provide clean bedding, and failure to safeguard personal possessions—were found to be unsubstantiated due to insufficient evidence to prove violations occurred.

The complaint alleged that resident #1 was illegally evicted after being discharged from one hospital and told they could not return to the facility. The investigation included interviews with the Executive Director, staff, residents, and hospital staff, and review of relevant records. The allegation was found unsubstantiated due to lack of evidence.

The investigation found no evidence to support the allegation of illegal eviction. Interviews with staff, residents, and hospital personnel, as well as record reviews, indicated the resident remained hospitalized and no eviction notice was issued. The allegation was determined to be unsubstantiated.

The complaint alleged that staff did not ensure a comfortable environment for residents. Interviews with staff and residents, as well as observations, indicated that the facility was maintained at a comfortable temperature with adequate lighting and cleanliness. The allegation was unsubstantiated due to lack of evidence.

Based on interviews with staff and residents, observations of the facility environment, and review of relevant documents, the Department found no evidence to support the allegation. The allegation was determined to be unsubstantiated and no deficiencies were issued.

The complaint alleged that staff did not assist a resident stuck between the bed and night stand and did not check on the resident in a timely manner. Interviews and record reviews showed that most staff and residents denied the allegations, and the evidence did not support the claims. The complaint was determined to be unsubstantiated.

The investigation included interviews with staff, residents, and a witness, as well as review of personnel and resident records. The allegations were found to be unsubstantiated due to lack of preponderance of evidence. No deficiencies were cited during the visit.

The complaint involved allegations that staff changed a resident's medication without notifying the primary psychiatrist or responsible parties, and that staff did not follow residents' special diets or occasionally failed to provide meals. The allegations were unsubstantiated based on record reviews and interviews.

The investigation found no preponderance of evidence to substantiate the allegations regarding medication dispensing and dietary needs. All interviewed staff and residents denied the allegations, and no deficiencies were cited during the visit.

The Licensing Program Analyst delivered the immediate exclusion letter to the Executive Director and explained that Staff #1 must be disassociated from the facility immediately. An exit interview was conducted and a copy of the report was provided to the Executive Director.

The complaint investigation was unsubstantiated. Allegations included poor food quality, inadequate planned activities, and failure to keep the facility free of pests. Interviews, observations, and record reviews did not support these allegations sufficiently to prove violations.

The investigation found no preponderance of evidence to substantiate the allegations. Interviews with residents and staff, record reviews, and observations indicated that the facility provides well-balanced meals with alternative options, offers various mentally and physically engaging activities, and maintains pest control with bi-monthly services. No deficiencies were cited.

The complaint investigation was unsubstantiated. Allegations included a resident sustaining pressure injuries, staff placing double diapers on a resident, and illegal eviction of a resident. The investigation found no preponderance of evidence to prove these allegations.

The investigation found no evidence to substantiate the allegations. Medical records, staff and resident interviews, and document reviews did not support claims of pressure injuries, double diapering, or illegal eviction. No deficiencies were cited.

The complaint involved three allegations: 1) Staff did not notify the authorized representative of a resident's fall; 2) Staff did not seek timely medical care for the resident; 3) Staff lost the resident's dentures. The investigation was unsubstantiated as no evidence was found to prove the alleged violations.

The investigation found no preponderance of evidence to substantiate the allegations. Staff interviews, resident interviews, and document reviews showed that notifications and medical care procedures were generally followed, and the facility's policies on personal property were consistent with the admission agreement. No deficiencies were cited.

The complaint investigation addressed three allegations: 1) Staff locked a resident inside their room; 2) Staff did not meet resident's dietary needs; 3) Staff did not allow residents to have personal food items. All allegations were found unsubstantiated based on interviews, observations, and record reviews.

The investigation found insufficient evidence to substantiate any of the allegations. Interviews with residents and staff, observations, and record reviews did not provide a preponderance of evidence to prove the alleged violations occurred, resulting in all allegations being unsubstantiated.

The facility was found to be well-maintained with adequate supplies, operational safety equipment, proper infection control practices, and accurate medication administration records. No deficiencies or violations were noted in the report.

Due to time constraints and technical difficulties, the inspection was not fully completed and a handwritten report was processed. The Licensing Program Analyst will return at a later date to conclude the annual inspection.

The complaint investigation addressed allegations that staff were not following food service sanitation practices, residents were fed contaminated foods, the facility was not kept free of pests, the kitchen was not kept clean, and staff yelled at residents. After thorough investigation including interviews, observations, and record reviews, all allegations were found unsubstantiated.

The investigation included interviews with staff and residents, observations of the kitchen and dining areas, and record reviews. No evidence was found to substantiate any of the allegations, and no deficiencies were cited. The allegations were all determined to be unsubstantiated.

The complaint alleged that the facility served a resident with an eviction notice and refused payment. The investigation determined the eviction notice was issued for nonpayment of rent, was properly sent to the licensing division, and complied with Title 22 regulations. The allegation was unsubstantiated.

The investigation found no evidence to support the allegation of illegal eviction. Records showed the eviction notice complied with regulations, and the resident subsequently paid the past due amount, leading to rescission of the eviction.

The complaint alleged poor quality food service, including serving cold food, running out of nonperishables for breakfast, refusal to serve certain proteins, and use of disposable utensils. The allegation was found to be unsubstantiated due to lack of preponderance of evidence.

The investigation found no evidence to support the allegation that staff serve food of poor quality. Observations, record reviews, and interviews indicated that food is served warm, alternative nonperishables are provided when needed, a variety of protein options are available, and metal silverware and cloth napkins are used except during kitchen remodeling.

No deficiencies were observed during the visit, and no citations were issued. Documentation including incident reports, staff schedules, resident rosters, and resident files were reviewed.

The complaint alleged that facility staff failed to assist resident #1 in arranging a medical appointment for posterior capsule opacification and that the facility was waiting for insurance matters to be resolved before transferring the resident. The investigation revealed that the resident was frustrated with the insurance process, which involved changing medical insurance carriers to see the preferred physician. Staff denied refusing assistance and explained the process. The resident confirmed the matter was resolved satisfactorily.

The investigation found no sufficient evidence to corroborate the allegation. Interviews with residents and staff, as well as review of medical and facility records, indicated that the facility staff were responsive and attentive in assisting with medical care appointments. The allegation was determined to be unsubstantiated and no deficiencies were cited.

The allegation was that staff spoke inappropriately to a resident. Interviews with 8 staff members and 8 residents found no evidence to support the claim. The allegation was unsubstantiated due to lack of sufficient evidence.

The investigation included interviews with staff and residents and a review of facility records. No evidence was found to substantiate the allegation, and the complaint was determined to be unsubstantiated.

The complaint alleged that resident #1 was evicted without prior notice, which was considered unlawful eviction. The investigation included interviews with staff, the resident, and a witness, as well as review of service records and facility observation. The allegation was found unsubstantiated due to lack of evidence.

The investigation found no evidence to support the allegation of unlawful eviction. Interviews, record reviews, and a facility tour indicated the resident voluntarily terminated residency and no eviction notice was required. The allegation was determined to be unsubstantiated.

The complaint alleged that the facility failed to provide resident records upon request. The allegation was found to be unsubstantiated after review of records and interviews with staff and residents.

The investigation found that all proper resident records were present and accessible. Interviews with staff and residents confirmed that records were not withheld and the record request had been fulfilled as of 03/21/2023. The allegation was unsubstantiated.

The facility was found to be sanitary and appropriately furnished with adequate infection control practices including screening protocols, PPE supply, and posted inspection control posters. No deficiencies were cited during this inspection visit.

The complaint involved allegations that a resident suffered from malnutrition, dehydration, serious injury resulting in hospitalization, was left unsupervised after a fall, and the facility failed to seek timely medical attention. The investigation included interviews with staff and review of medical records. All allegations were found unsubstantiated.

The investigation found that although the resident had a history of malnutrition and dehydration, the allegations were not substantiated based on interviews and medical record reviews. The resident's fall was unwitnessed but medical attention was timely and appropriate. Overall, the allegations were unsubstantiated due to lack of preponderance of evidence.