Inspection Reports for Westmont of Pinole
2850 Estates Ave, Pinole, CA 94564, United States, CA, 94564
Back to Facility ProfileInspection Report Summary
Most inspections found deficiencies related primarily to medication management and safeguarding resident property, with several substantiated complaints about improper medication administration and failure to notify residents’ representatives about rate increases. The facility was cited for immediate health and safety risks due to medication errors in the most recent report dated September 10, 2025. Earlier issues included insufficient staffing in late 2022 and failure to follow infection control and COVID reporting protocols in 2021 and 2022, but many complaint investigations were unsubstantiated. The most recent report shows ongoing challenges with medication administration despite prior training efforts. There is no mention of fines, license suspensions, or enforcement actions in the available reports.
Deficiencies per Year
4
3
2
1
0
High
Moderate
Census Over Time
Census
Capacity
Inspection Report
Follow-Up
Census: 85
Capacity: 100
Deficiencies: 1
Sep 10, 2025
Visit Reason
Unannounced Case Management inspection to follow-up on an incident report received regarding a medication error involving incorrect dosage administration.
Findings
The facility failed to comply with medication administration orders, resulting in a resident receiving a whole tablet of Hydrocodone instead of the prescribed half tablet, posing an immediate health and safety risk. The facility contacted appropriate parties and conducted in-service training for medication staff.
Complaint Details
Inspection was triggered by an incident report received on 2025-08-27 regarding a medication error. Resident was monitored and showed no side effects. Facility conducted in-service training on medication for med techs.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to comply with medication administration orders resulting in incorrect dosage of Hydrocodone - Acetaminophen given to resident, posing immediate health and safety risk. | Type A |
Report Facts
Census: 85
Total Capacity: 100
Deficiency Count: 1
Plan of Correction Due Date: Due date is 2025-09-11 as stated in text
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nhi Nguyen | Resident Service Director | Discussed incident details and conducted in-service training on medication |
| Carol Fowler | Licensing Program Analyst | Conducted inspection and signed report |
| David Doidge | Licensing Program Analyst | Conducted inspection |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 84
Capacity: 100
Deficiencies: 1
Jul 25, 2025
Visit Reason
Unannounced complaint investigation visit conducted due to an allegation that staff mismanaged resident's medications.
Findings
Investigation found that residents were given incorrect numbers and dosages of medications, including late administration and overmedication, substantiating the complaint. The licensee failed to comply with medication management regulations, posing immediate health and personal rights risks.
Complaint Details
Complaint was substantiated based on review of records and interviews. The allegation was that staff mismanaged resident's medications, including giving more medications than prescribed and late administration.
Severity Breakdown
Type A: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Licensee did not comply with medication management requirements, mismanaging resident's medications and administering incorrectly, posing immediate health and personal rights risks. | Type A |
Report Facts
Census: 84
Total Capacity: 100
Deficiency Type: 1
Plan of Correction Due Date: Jul 26, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Richard Remigio | Executive Director | Met with Licensing Program Analyst during investigation and discussed findings |
| Alicia Delmundo | Licensing Program Analyst | Conducted the complaint investigation |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager overseeing investigation |
Inspection Report
Complaint Investigation
Census: 81
Capacity: 100
Deficiencies: 1
Mar 28, 2025
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 11/01/2023 regarding staff mishandling resident's supplies and other care concerns.
Findings
The investigation substantiated the allegation that staff mishandled a resident's supplies, failing to safeguard personal property, posing a risk to persons in care. Other allegations regarding inaccurate records, diapering, hygiene, and staffing sufficiency were found unsubstantiated.
Complaint Details
The complaint investigation was substantiated for staff mishandling resident's supplies. Other allegations including failure to maintain accurate records, meet diapering and hygiene needs, and insufficient staffing were unsubstantiated. The substantiated deficiency cites noncompliance with CCR 87218 (a)(2) regarding safeguarding resident property.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure an adequate theft and loss program and safeguard resident property, resulting in missing personal supplies and property of resident R1. | Type B |
Report Facts
Capacity: 100
Census: 81
Deficiency count: 1
POC Due Date: Apr 4, 2025
Incontinence supplies program cost: 125
Staff per shift: 4
Residents per caregiver: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Richard Remigio | Executive Director | Met with Licensing Program Analyst during investigation and named in findings |
| Lori Alexander-Washington | Licensing Program Analyst | Conducted the complaint investigation visit and authored the report |
| Bennett Fong | Licensing Program Manager | Named as Licensing Program Manager overseeing the investigation |
Inspection Report
Complaint Investigation
Census: 84
Capacity: 100
Deficiencies: 0
Dec 23, 2024
Visit Reason
An unannounced complaint investigation was conducted due to an allegation that staff did not prevent a resident from physically abusing another resident resulting in injury.
Findings
After interviews, observations, and record reviews, the allegation was found to be unsubstantiated. The resident in question was monitored closely by staff due to confusion and aggressive behavior, and safety checks were conducted regularly.
Complaint Details
The complaint alleged that staff failed to prevent physical abuse between residents resulting in injury. The investigation included interviews with staff and residents, facility tour, and record review. The allegation was found to be unsubstantiated.
Report Facts
Capacity: 100
Census: 84
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kelly Nguyen | Licensing Program Analyst | Conducted the complaint investigation |
| Richard Remigio | Executive Director | Met with Licensing Program Analyst during investigation |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Census: 73
Capacity: 100
Deficiencies: 0
Oct 8, 2024
Visit Reason
The visit was an unannounced case management inspection conducted by Licensing Program Analysts to review the circumstances surrounding a resident who was hit by a car.
Findings
The investigation revealed that the resident was hit by a car while crossing a crosswalk with a green light. The resident received assistance from bystanders, police, staff, and ambulance personnel and is able to leave the facility unassisted. No deficiencies were cited during this visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Richard Remigio | Executive Director | Interviewed regarding the resident hit by a car and the case management visit. |
| Carol Fowler | Licensing Program Analyst | Conducted the case management visit. |
| David Doidge | Licensing Program Analyst | Conducted the case management visit. |
| Bennett Fong | Licensing Program Manager | Named in the exit interview section. |
Inspection Report
Complaint Investigation
Capacity: 100
Deficiencies: 0
Oct 1, 2024
Visit Reason
The visit was an unannounced complaint investigation triggered by an allegation that a resident sustained unexplained injuries while in care.
Findings
The investigation found the allegation to be unsubstantiated due to lack of preponderance of evidence. Interviews with the reporting party, resident, and witness indicated uncertainty about how the small wounds occurred, and no deficiencies were observed during the visit.
Complaint Details
The allegation was that a resident sustained unexplained injuries while in care. The reporting party witnessed small wounds on the resident during visits but had no evidence of harm by staff. The resident and witness also were unsure how the wounds occurred. The allegation was unsubstantiated.
Report Facts
Capacity: 100
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carol Fowler | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
| Richard Remigio | Executive Director | Met with Licensing Program Analyst during investigation |
Inspection Report
Complaint Investigation
Census: 69
Capacity: 100
Deficiencies: 0
Jun 12, 2024
Visit Reason
The inspection was an unannounced complaint investigation conducted due to an allegation that residents were isolated due to lack of staff.
Findings
The investigation included interviews, record reviews, and facility tours which revealed that memory care and assisted living were fully staffed, safety checks were conducted every two hours, and residents were encouraged to participate in activities. The allegation was found to be unsubstantiated.
Complaint Details
The complaint alleged that residents were isolated due to lack of staff. The investigation found the allegation to be unsubstantiated.
Report Facts
Capacity: 100
Census: 69
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carol Fowler | Licensing Program Analyst | Conducted the complaint investigation |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
| Shanece Tupuola | Memory Care Coordinator | Met with Licensing Program Analyst during investigation |
| Richard Remigio | Administrator | Facility administrator named in report |
Inspection Report
Complaint Investigation
Census: 69
Capacity: 100
Deficiencies: 0
Jun 12, 2024
Visit Reason
An unannounced complaint investigation was conducted in response to allegations that staff did not safeguard resident's personal items, did not provide resident medication as prescribed, and did not provide daily activities for residents.
Findings
Based on interviews, facility tour, and record review, the Department found the allegations to be unsubstantiated. Residents were observed participating in activities and medications were given as prescribed except for one missed medication due to prescription coverage issues.
Complaint Details
The complaint investigation was unsubstantiated. Allegations included failure to safeguard personal items, failure to provide medication as prescribed, and failure to provide daily activities. Interviews with staff and review of records supported that medications were administered as prescribed and activities were provided. Missing items were reported and searched for according to facility protocol.
Report Facts
Capacity: 100
Census: 69
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carol Fowler | Licensing Program Analyst | Conducted the complaint investigation |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
| Shanece Tupuola | Memory Care Coordinator | Met with Licensing Program Analyst during investigation |
Inspection Report
Annual Inspection
Census: 67
Capacity: 100
Deficiencies: 0
Mar 7, 2024
Visit Reason
An unannounced 1-Year Required inspection was conducted to evaluate the facility's compliance with licensing regulations.
Findings
The facility was found to be in good condition with no deficiencies cited. All safety measures, including fire clearance, emergency plans, and hygiene standards, were met. Staff records and client files were reviewed and found compliant.
Report Facts
Fire clearance capacity: 140
Number of staff records reviewed: 5
Number of client files reviewed: 10
Fire extinguisher last serviced: Jan 17, 2024
Fire drill last conducted: Feb 24, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Richard Remigio | Administrator | Named in relation to certificate renewal and facility administration |
| Kathleen Boyd | Business Office Manager | Met with Licensing Program Analyst during inspection |
| Carol Fowler | Licensing Program Analyst | Conducted the inspection |
| Bennett Fong | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 67
Capacity: 100
Deficiencies: 0
Mar 7, 2024
Visit Reason
The visit was a case management incident investigation conducted due to an un-witnessed fall of resident R1 found on the bathroom floor.
Findings
During the investigation, it was found that R1 was transferred to Richmond Kaiser and returned to the community on the same day, able to transfer and perform activities of daily living with assistance. No deficiencies were issued during the visit.
Complaint Details
The investigation was related to an un-witnessed fall of resident R1, who was found on the bathroom floor and transferred to the hospital. The complaint was investigated and no deficiencies were found.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carol Fowler | Licensing Program Analyst | Conducted the case management visit and investigation. |
| Kathleen Boyd | Business Office Manager | Met with the Licensing Program Analyst during the visit. |
| Richard Remigio | Administrator | Administrator to whom the purpose of the visit was explained. |
Inspection Report
Complaint Investigation
Census: 66
Capacity: 100
Deficiencies: 1
Aug 22, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that the resident's representative was not provided with a general description of costs pertaining to a rate increase.
Findings
The investigation found that the facility failed to provide the resident's representative with a general description of costs related to the rate increase and failed to provide proof of correspondence to the Department, substantiating the allegation.
Complaint Details
The complaint was substantiated. The allegation was that the resident's representative was not provided with a general description of costs pertaining to a rate increase. The Department confirmed this failure based on interviews and record review.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failed to provide written notice to resident/responsible party establishing a rate increase which poses a potential health and safety risk to residents in care. | Type B |
Report Facts
Capacity: 100
Census: 66
Plan of Correction Due Date: 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daisy Panlilio | Licensing Program Analyst | Conducted the complaint investigation and subsequent visit |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
| Richard Remigio | Administrator | Met with during inspection visit |
Inspection Report
Complaint Investigation
Census: 61
Capacity: 100
Deficiencies: 0
May 23, 2023
Visit Reason
An unannounced complaint investigation was conducted in response to allegations received on 2022-02-17 regarding resident injury, rough handling by staff, prolonged exposure to soaked diapers, feeding issues, and safeguarding of personal items.
Findings
The investigation included interviews with residents, staff, witnesses, and review of relevant documents. No evidence was found to substantiate the allegations, and the complaint was determined to be unsubstantiated.
Complaint Details
The complaint investigation was unsubstantiated as there was no preponderance of evidence to prove the alleged violations occurred.
Report Facts
Capacity: 100
Census: 61
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Luk | Licensing Program Analyst | Conducted the complaint investigation |
| Benjie Doctolero | Executive Director | Met with Licensing Program Analyst during investigation |
| Harpreet Humpal | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Capacity: 100
Deficiencies: 0
Apr 6, 2023
Visit Reason
An unannounced Case Management visit was conducted to deliver an amended report related to complaint #15-AS-20220630152422.
Findings
The Licensing Program Analyst amended the complaint report, citing 2 allegations on 1 regulation. No deficiencies were issued during the visit.
Complaint Details
The visit was related to an amended complaint with 2 allegations cited on 1 regulation.
Report Facts
Allegations cited: 2
Regulations cited: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Benjie Doctolero | Administrator | Met with Licensing Program Analyst during the visit. |
| Carol Fowler | Licensing Program Analyst | Conducted the unannounced Case Management visit and amended the complaint report. |
| Bennett Fong | Licensing Program Manager | Named in the report header. |
Inspection Report
Routine
Census: 54
Capacity: 100
Deficiencies: 0
Feb 23, 2023
Visit Reason
The visit was an unannounced Infection Control Inspection conducted as a required 1-year routine inspection.
Findings
The facility was found to have adequate infection control measures including proper PPE use, screening procedures, and sufficient food and PPE supplies. No deficiencies were cited during the visit.
Report Facts
Capacity: 100
Census: 54
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Benjie Doctolero | Administrator | Met with Licensing Program Analyst during inspection |
| Carol Fowler | Licensing Program Analyst | Conducted the Infection Control Inspection |
| Bennett Fong | Licensing Program Manager | Named in report header |
Inspection Report
Complaint Investigation
Census: 54
Capacity: 100
Deficiencies: 2
Feb 23, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by allegations received on 06/30/2022 regarding improper notification of resident rate increases and communication issues.
Findings
The investigation substantiated that the facility failed to provide proper notification to the resident's representative regarding rate increases, including the reason and general description of costs. Other allegations related to resident hygiene needs and communication requests were found unsubstantiated.
Complaint Details
The complaint investigation was substantiated for allegations that the resident's rates were raised without proper notification, the resident's representative was not provided with a notice setting forth the reasons for the rate increase, and was not provided with a general description of costs pertaining to the rate increase. Other allegations regarding resident hygiene needs and communication requests were unsubstantiated.
Severity Breakdown
Type B: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to provide written notice to resident/responsible party establishing level of care change and/or rate increase. | Type B |
| Facility failed to provide written notice establishing a rate increase which poses a potential health and safety risk to residents in care. | Type B |
Report Facts
Capacity: 100
Census: 54
Rate increase percentage: 14.9
Deficiencies cited: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Benjie Doctolero | Administrator | Met with Licensing Program Analyst during investigation |
| Carol Fowler | Licensing Program Analyst | Conducted the complaint investigation |
| Bennett Fong | Licensing Program Manager | Oversaw complaint investigation |
Inspection Report
Complaint Investigation
Census: 51
Capacity: 100
Deficiencies: 1
Dec 15, 2022
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation of insufficient staffing to meet residents' needs.
Findings
The investigation found that the facility was short staffed in November, with fewer staff working than scheduled on at least one day, leading to a substantiated finding of insufficient staffing posing a potential health and safety risk.
Complaint Details
The complaint investigation was substantiated based on interviews and record reviews showing insufficient staffing during November, specifically on 11/24/2022 when only two staff were working instead of three as scheduled.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| 87705 Care of Persons with Dementia (4) There is an adequate number of direct care staff to support each resident’s physical, social, emotional, safety and health care needs as identified in his/her current appraisal. This requirement is not met as evidenced by facility not having an adequate number of staff for residents which poses a potential health and safety risk. | Type B |
Report Facts
Capacity: 100
Census: 51
Staff scheduled vs working: 3
Staff actually working: 2
Plan of Correction Due Date: Dec 22, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carol Fowler | Licensing Program Analyst | Conducted the complaint investigation |
| Jerrick Hall | Resident Service Director | Met with during investigation |
| Bennett Fong | Licensing Program Manager | Named in report as Licensing Program Manager |
Inspection Report
Complaint Investigation
Census: 54
Capacity: 100
Deficiencies: 1
Jul 21, 2022
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that staff were not following COVID protocols.
Findings
The investigation found that the facility failed to report COVID positive staff and residents to the Community Care Licensing Division (CCLD) and Local Public Health, which poses a potential health and safety risk. The allegation was substantiated based on observations, interviews, and record reviews.
Complaint Details
The complaint was substantiated. The allegation was that staff were not following COVID protocols, specifically failing to report COVID positive cases to the licensing agency and public health authorities.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to submit required reports of COVID positive staff and residents to the licensing agency within the required timeframe. | Type B |
Report Facts
Capacity: 100
Census: 54
Plan of Correction Due Date: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Carol Fowler | Licensing Program Analyst | Conducted the complaint investigation |
| Bennett Fong | Licensing Program Manager | Oversaw the complaint investigation |
| Kathy Boyd | Business Office Director | Met with LPAs during the investigation and agreed to submit required reports |
| Josephine Davis | Administrator | Facility administrator named in the report |
Inspection Report
Annual Inspection
Census: 48
Capacity: 100
Deficiencies: 0
Apr 15, 2022
Visit Reason
The visit was an unannounced 1-Year Annual Required inspection conducted to evaluate the facility's compliance with licensing requirements.
Findings
The inspection found no deficiencies. The facility was toured including resident apartments, bathrooms, activity rooms, kitchen, common areas, and courtyard. Safety measures such as adequate lighting, temperature control, hot water temperature, and secure storage of medications were observed and found compliant.
Report Facts
Fire clearance capacity: 100
Hot water temperature: 113.9
Hallway temperature: 70
Nonperishable food supply: 7
Perishable food supply: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nhi Nguyen | Memory Care Director | Met with Licensing Program Analyst during inspection and toured facility |
Inspection Report
Complaint Investigation
Census: 48
Capacity: 100
Deficiencies: 0
Feb 18, 2022
Visit Reason
An unannounced Health & Safety inspection was conducted as a result of a priority 2 complaint.
Findings
The facility was toured including bedrooms, bathrooms, common areas, kitchen, and outdoor area. All safety measures such as hot water temperature, food supplies, refrigerator and freezer temperatures, medication storage, smoke and carbon monoxide detectors, first-aid kit, and fire extinguisher were found to be in compliance. No deficiencies were cited on this date.
Complaint Details
The visit was triggered by a priority 2 complaint; no deficiencies were found and no substantiation status was stated.
Report Facts
Hot water temperature: 118.1
Non-perishable food supply duration: 7
Perishable food supply duration: 2
Refrigerator temperature: 39
Freezer temperature: -0.5
Fire extinguisher last serviced: Feb 8, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Donna Bautista-Colmenares | Executive Director | Met with Licensing Program Analyst during inspection |
| Grace Luk | Licensing Program Analyst | Conducted the inspection |
| Harpreet Humpal | Licensing Program Manager | Named in report header |
Inspection Report
Follow-Up
Census: 48
Capacity: 100
Deficiencies: 0
Feb 18, 2022
Visit Reason
The visit was an unannounced proof of correction (POC) inspection to verify correction of a deficiency cited during a complaint investigation conducted on 2022-02-09.
Findings
The Licensing Program Analyst observed compliance with infection control measures including posted 'yellow zone' signs, PPE stations on each floor, and staff wearing N95 masks and face shields. The deficiency cited previously was cleared on this date, and no new deficiencies were cited.
Complaint Details
The visit was related to a complaint investigation conducted on 2022-02-09. The deficiency cited was for CCR 87468.1(a)(2) and was cleared as of 2022-02-18.
Report Facts
Capacity: 100
Census: 48
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Donna Bautista-Colmenares | Executive Director | Met with Licensing Program Analyst during the visit |
| Grace Luk | Licensing Program Analyst | Conducted the proof of correction visit |
| Harpreet Humpal | Licensing Program Manager | Named in the report header |
Inspection Report
Complaint Investigation
Census: 49
Capacity: 100
Deficiencies: 1
Feb 9, 2022
Visit Reason
Unannounced complaint investigation conducted due to an allegation that the facility was not following infection control guidelines.
Findings
The investigation found that staff were not following infection control guidelines, including lack of dedicated staff for positive residents, improper use of PPE, and unauthorized new admissions during an active outbreak. The allegation was substantiated.
Complaint Details
The complaint was substantiated based on evidence that staff were co-mingling between positive and negative residents, improper PPE use, and unauthorized new admissions during an active outbreak.
Severity Breakdown
Type B: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility did not comply with infection control guidelines, posing a potential health and safety risk to persons in care. | Type B |
Report Facts
Census: 49
Total Capacity: 100
New Admissions: 3
Plan of Correction Due Date: Feb 15, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Grace Luk | Licensing Program Analyst | Conducted the complaint investigation and delivered findings |
| Harpreet Humpal | Licensing Program Manager | Oversaw the complaint investigation |
| Syritta Rogers | Resident Service Director | Met with Licensing Program Analyst during investigation |
| Christina Ponce | Infection Prevention Control Program Manager | Present during investigation |
| Lydia Hertzler | Regional Director of Operations | Met with Licensing Program Analyst during investigation |
Inspection Report
Complaint Investigation
Census: 54
Capacity: 100
Deficiencies: 0
Jul 21, 2021
Visit Reason
An unannounced complaint investigation visit was conducted following a complaint received on 05/18/2021 regarding a resident sustaining an unexplained, suspicious injury.
Findings
The investigation found that resident R1 had two unwitnessed falls resulting in injuries, but there was insufficient evidence to prove a violation occurred; therefore, the allegation was unsubstantiated.
Complaint Details
The complaint alleged that a resident sustained an unexplained, suspicious injury. The investigation concluded the allegation was unsubstantiated due to lack of preponderance of evidence.
Report Facts
Facility capacity: 100
Census: 54
Complaint control number: 15-AS-20210518160827
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daisy Panlilio | Licensing Program Analyst | Conducted the complaint investigation and subsequent visit |
| Patrick Frazier | Operations Specialist/administrator | Met with during the investigation |
Inspection Report
Complaint Investigation
Census: 55
Capacity: 100
Deficiencies: 0
May 20, 2021
Visit Reason
The visit was an unannounced Health and Safety check conducted as a result of the department receiving a priority 2 complaint.
Findings
The Licensing Program Analyst observed staff wearing face masks, COVID-19 safety signs, and screening procedures in place. Residents appeared safe with no imminent health or safety concerns, and no deficiencies were cited during the check.
Complaint Details
The visit was triggered by a priority 2 complaint. No deficiencies were cited, indicating no substantiated violations.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Daisy Panlilio | Licensing Program Analyst | Conducted the unannounced Health and Safety check and observed compliance with COVID-19 safety measures. |
| Josephine Davis | Administrator | Facility administrator who met with the Licensing Program Analyst during the visit. |
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