Failure to Timely Report Allegations of Physical Abuse
Penalty
Summary
The facility failed to report allegations of physical abuse to the California Department of Public Health (CDPH) within 24 hours for three residents. One resident with moderate cognitive impairment reported that during a shower, a CNA was rough, applied excessive soap to her face, and did not stop until the resident screamed. The resident stated she reported the incident to the department head, who said they would monitor the CNA, but the CNA continued to work in the facility and entered her room. The DON was not aware of this incident until several days later. Another resident, who was cognitively intact, reported that a CNA was rough and pulled her paralyzed arm during a shower, and later confronted her about reporting the incident. A third resident, also cognitively intact, stated that the same CNA was rough during a shower, causing pain, and has since refused showers from that CNA. Interviews with the DON and DSD revealed that they were not aware of all three abuse allegations prior to the survey, and the incidents were not reported to CDPH as required by facility policy.