Inspection Reports for The Avant

The visit was a case management inspection conducted to inquire about the employment status of a specific staff member (staff #1).

No deficiencies were cited during this unannounced case management visit. The licensing program analyst met with the health and wellness director and spoke with the executive director by phone regarding staff employment status.

The inspection visit was conducted as a Case Management – Incident inspection regarding a reported Theft and Loss incident that occurred on 07/17/2025 involving missing art pieces belonging to resident R1.

The investigation found that four art pieces were missing from R1's closet, with no evidence found during a staff search of the room. The police were contacted but due to lack of evidence, the incident was filed online. No deficiencies were cited during the visit.

The visit was complaint-related due to a reported Theft and Loss incident involving missing art pieces valued at $160. The complaint was investigated, but no evidence was found to substantiate theft by staff. The resident and DPOA were satisfied with the investigation.

The inspection visit was conducted as a Case Management – Incident visit regarding an incident on 2025-07-02 where Resident #1 placed their hand on Resident #2's left chest.

The investigation found that the contact was indirect with no physical injuries observed. The facility took appropriate actions including notifying police, physicians, updating medication and service plans, and implementing an intervention plan. Staff training was conducted and no deficiencies were cited during the visit.

The visit was complaint-related due to an incident between two residents involving inappropriate contact. The incident was reported to police and the Ombudsman, who determined no further reporting was needed due to lack of physical injury. The facility monitored the residents closely and implemented intervention and safety measures.

The inspection visit was conducted unannounced on May 28, 2025, regarding a reported staff-to-resident physical abuse incident that occurred on May 17, 2025.

The investigation found that caregiver S1 inappropriately slapped and tapped resident R1 during a combative episode, but no injuries were noted upon assessment. S1 was suspended and subsequently terminated. Resident R1 was observed to be calm and reported no pain or memory of the incident. No deficiencies were cited during the visit.

The visit was complaint-related due to a reported staff-to-resident physical abuse incident on 05/17/2025. The allegation was investigated, and no injuries were found. The staff member involved was suspended and terminated. The resident's responsible party was notified and had no concerns. Police were contacted but no in-person response occurred.

The inspection was an unannounced Required 1-Year Annual inspection conducted to evaluate the facility's compliance with licensing requirements.

The facility was found to be clean, well-maintained, and compliant with all applicable regulations. Emergency systems, medication storage, and recreational areas were inspected and found satisfactory. No deficiencies were cited during the visit.

The visit was an unannounced complaint investigation triggered by an allegation that staff did not provide adequate supervision, resulting in a resident wandering into an unsafe area, specifically the locked garage.

The investigation found that a resident had accessed the basement garage and wandered into the Meadow Wing Memory Care Unit without harm. The elevators and garage were deemed safe with regular maintenance and alarms. The resident was assessed with no injuries or distress. The allegation was determined to be unsubstantiated due to lack of preponderance of evidence.

The complaint alleged inadequate supervision leading to a resident wandering into an unsafe area. The resident, recovering from brain surgery and with memory issues, was found in the basement garage and later in the Memory Care Unit. Interviews and records showed no injuries or distress, and safety measures were in place. The allegation was unsubstantiated.

The inspection visit was an unannounced Case Management - Incident visit regarding a medication error incident on 03/19/2025 where a resident (R1) was given a PRN medication by mistake.

The facility staff administered a PRN medication ('Labetalol') to resident R1 without meeting the physician's specified parameters, posing an immediate health and safety risk. The error was acknowledged by staff, reported to the resident's PCP, and communicated to the resident's family. A deficiency was cited for failure to ensure medication was given according to physician's directions.

The visit was triggered by a complaint or incident involving a medication error where resident R1 was given 'Labetalol' as a routine medication instead of as needed, contrary to physician orders. The medication error was substantiated based on observations, interviews, and record reviews.

The inspection visit was conducted as a Case Management – Incident inspection regarding an incident where a resident presented with a sudden change of condition and had removed his suprapubic catheter.

The facility did not have an exception granted for the resident's suprapubic catheter, but no deficiencies were cited during the visit. The facility had documents ready to submit for an exception request if needed.

The visit was triggered by an incident involving a resident removing his suprapubic catheter. The Vice President of Clinical Services stated there was no need to file an exception request for the catheter after a call with CDSS.

An unannounced complaint investigation visit was conducted in response to allegations received on 07/21/2022 regarding resident hygiene and diaper changing practices at the facility.

Based on interviews with staff and the administrator, as well as review of resident assessments and training logs, there was insufficient evidence to substantiate the allegations. Staff reported regularly assisting the resident with oral care and diaper changes, and no deficiencies were cited.

The complaint alleged that the resident's hygiene needs were not being met and that staff were not changing the resident's diaper. The investigation found no preponderance of evidence to prove the alleged violations occurred, and the complaint was unsubstantiated.

The inspection visit was conducted as a Case Management – Incident inspection regarding a reported Theft and Loss incident that occurred on 2025-02-24 involving missing personal items of a deceased hospice resident.

The facility reported a theft and loss incident involving multiple missing items valued at $14,275.00 from a resident's room. The police were contacted and a case was opened. No deficiencies were cited during the visit.

The complaint involved a theft and loss incident reported by a family member of a deceased resident. The family member reported missing items including a wallet, watch, Apple iPad, camera equipment, music box, and Faberge Pinecone Egg. The facility cooperated with the police investigation. No substantiation status was explicitly stated.

The purpose of the visit was to obtain copies of resident records during an unannounced Case Management visit.

No deficiencies were cited at this time as per California Code of Regulations Title 22.

The visit was an unannounced complaint investigation conducted in response to an allegation that staff were holding a resident against their will.

After interviews and record reviews, it was determined that the allegation was unfounded. The resident was not being held against their will, was free to move around the facility, and no deficiencies were cited.

The complaint alleged that staff were holding Resident R2 against their will and that R2's care nurse placed R2 in the facility without proper consultation with R2's primary care physician. The investigation found no evidence to support this claim, and the allegation was determined to be unfounded.

The inspection was an unannounced complaint investigation visit triggered by multiple allegations received on 07/18/2023 regarding resident accommodations, privacy, room disrepair, lack of planned activities, and insufficient staffing.

The investigation substantiated the allegation of insufficient staffing as resident R1 was left in bed multiple times past 1 PM, posing an immediate health risk. Other allegations regarding accommodations, privacy, room disrepair, and activities were unsubstantiated due to lack of preponderance of evidence. The facility was undergoing renovations and had scheduled activities for residents.

The complaint investigation was initiated based on allegations received on 07/18/2023. The allegations included staff not providing comfortable accommodations, lack of privacy, room disrepair, lack of planned activities, and insufficient staffing. The allegation of insufficient staffing was substantiated based on interviews and observations, while other allegations were unsubstantiated. The report notes that the occupational therapist and resident reported staff leaving R1 in bed late in the day, and the facility agreed to submit a plan of correction.

The inspection was an unannounced case management visit to follow up on an incident where a resident (R1) eloped from the facility unsupervised on 2024-11-04 after attending a birthday concert.

The facility staff failed to prevent R1, who has dementia and is non-ambulatory due to mental condition, from leaving the facility unassisted, posing an immediate health, safety, or personal rights risk. An immediate civil penalty of $500 was assessed for the absence of supervision.

The visit was complaint-related due to an incident where resident R1 eloped from the facility unsupervised. The complaint was substantiated as the facility failed to ensure R1 did not leave unassisted, posing immediate risk.

An unannounced Case Management - Annual Continuation Visit was conducted to review compliance with regulations and assess facility conditions.

The Licensing Program Analyst reviewed medication and destruction records, resident and staff records, and toured resident living units, bathrooms, and outside areas. No deficiencies were cited during this inspection.

An unannounced Required - 1 Year visit was conducted as part of the annual inspection process.

No deficiencies were cited at this time as per California Code of Regulations Title 22. The inspection included interviews with residents and staff, review of the first aid kit, fire drill records, smoke detector testing, and kitchen food supply observations.

The visit was conducted to address an incident self-reported by the facility involving a private duty caregiver driving an independent living resident to a bank and the subsequent withdrawal of $6,500 by the resident.

During the visit, the Licensing Program Analyst interviewed the administrator and residents. The private caregiver admitted to driving the resident to the bank and receiving $200 as a gift, while $6,300 remains missing and unaccounted for. No deficiencies were cited at this time.

The visit was complaint-related, triggered by an incident reported on 02/20/2024 concerning a private caregiver driving a resident to a bank and the missing $6,300 according to the resident's Financial Power of Attorney.

The visit was an unannounced complaint investigation triggered by a report received on 2022-01-07 alleging that the facility does not follow COVID-19 guidelines.

The investigation included interviews and record reviews but was unable to prove whether the facility did not follow COVID-19 guidelines. The allegation was determined to be unsubstantiated and no deficiencies were cited during the visit.

The complaint alleged that the facility did not follow COVID-19 guidelines. The investigation found insufficient evidence to substantiate the allegation, resulting in an unsubstantiated finding.

The visit was conducted to follow up on an Incident Report and Suspected Adult/Elderly Abuse Form submitted by the facility regarding a resident's fall and concerns about staff reporting accuracy.

The investigation included interviews with staff and a family member, observation of the resident, and review of the incident. No deficiencies were cited as the staff were found not to have neglected the resident and no withholding of information was substantiated.

The visit was complaint-related, following up on an incident report of a resident fall and alleged inaccurate reporting by staff. The complaint was not substantiated as staff and family member interviews did not support neglect or withholding information.

The visit was an unannounced Case Management visit to inquire about an incident self-reported by the facility regarding a stolen resident's bicycle on 05/29/2023.

The facility provided camera footage showing the theft, filed a police report, installed alarms on the gate door, and conducted staff training on theft and loss policy. No deficiencies were cited during the visit.

The visit was an unannounced Case Management visit in response to an incident involving resident R1 leaving the facility without supervision on 2023-03-22, reported via an Unusual Injury/Incident Report on 2023-03-24.

The Licensing Program Analyst reviewed resident and staff records, confirming that R1 has dementia and requires supervision. Staff conduct safety checks every 2 hours and escort R1 to meals. An Advisory Note was issued, but no deficiencies were cited at this time according to California Code of Regulations Title 22.

An unannounced Required 1 Year visit was conducted to evaluate the facility's compliance with regulations.

The facility was toured inside and outside, with observations including visitor screening, availability of soap and paper towels, hand washing posters, adequate food supplies, and PPE supplies. No deficiencies were cited during this inspection.

The inspection was an unannounced complaint investigation visit triggered by an allegation that the facility did not have hot water for residents in care.

The Licensing Program Analyst investigated the complaint by interviewing staff and residents, reviewing records, and observing the facility. Although some residents reported issues with hot water temperature, the facility had taken corrective actions including installing a storage and mixing tank. The allegation was determined to be unsubstantiated with no deficiencies cited.

The complaint alleged that the facility did not have hot water for residents in care. The investigation found some residents experienced hot water temperature issues, but the facility addressed plumbing problems promptly. The allegation was unsubstantiated due to lack of preponderance of evidence.

An unannounced prelicensing visit was conducted to evaluate the facility for initial licensing approval.

The facility was toured and inspected, including resident living units, dining area, kitchen, medication logs, personnel records, and emergency systems. No deficiencies were found during the prelicensing inspection.