306004543-8-31-2023-22-AS-SSAS-CVPS6M-20230915133610

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004543
Report Date: 08/30/2023
Date Signed: 08/31/2023 07:09:25 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/12/2021 and conducted by Evaluator Lydia Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20210212003828

FACILITY NAME:	GOLDEN TUSCANY CARE		FACILITY NUMBER:	306004543
ADMINISTRATOR:	DANIEL RESCIA		FACILITY TYPE:	740
ADDRESS:	2825 E. DUTCH AVENUE		TELEPHONE:	(714) 234-6348
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92806
CAPACITY:	6	CENSUS: 4	DATE:	08/30/2023
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Evangeline Bulaon		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff inflicted injuries to resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Lydia Martinez conducted an unannounced visit to the facility to deliver findings on the above allegation. LPA identified herself and discussed the purpose of the visit with Evangeline Bulaon. The complaint was investigated by the Department. Administrator Daniel Rescia was notified of LPA's presence at the facility via telephone.

During the investigation, LPA conducted a virtual inspection on 02/18/2021 and requested and obtained photos of Resident 1’s (R1) injuries, picture of a cell phone showing R1’s 911 call on 2/11/2021, R1’s Physician’s Report dated 2/8/2021, a statement account of the incident on 2/11/2021 written by Administrator Daniel Rescia (AD) and a statement account of the incident on 2/11/2021 written by Witness 1 (W1). The Department interviewed 5 witnesses, 3 staff, and obtained and reviewed police report and hospital records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Lydia Martinez	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20210212003828

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: GOLDEN TUSCANY CARE	FACILITY NUMBER: 306004543
	VISIT DATE: 08/30/2023

NARRATIVE

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It was reported that R1 was found with bruising and R1 reported R1 was abused by staff at the facility. The investigation did not produce substantial evidence to support an allegation of physical abuse. The Anaheim Police Department report was obtained, which contained interviews with R1, W1, Staff 1 and Staff 2.

The Department conducted interviews with W1, R1’s primary physician, Anaheim Police Department Personnel and Staff 1 and Staff 2. Medical records were obtained and reviewed from Orange Coast Memorial Care where R1 was transported to following a physical altercation incident. No statements or information could be obtained to substantiate the allegation. In an interview with W1 who stated she did not suspect any foul play or abuse by facility staff and concluded R1 caused the mark on the neck by scratching self. W1 stated she has never observed any marks or bruises on R1 that would make W1 suspicious of abuse or aggressive handling. W1 stated R1 never complained or disclosed any mistreatment. W1 reported she would visit R1, 2 to 3 times a week. W1 did report she believes she caused the injuries to R1’s arms (scratches/bruises) by grabbing at R1’s arms to restrain R1 from assaulting her when she was bringing R1 back to the facility on 2/11/2021 from an outing and not the facility staff. W1 stated staff responded appropriately when assisting with R1 when R1 was being aggressive towards her. W1 reported R1 was diagnosed with a UTI at the hospital and that could cause aggressive behavior. Interview with R1’s Primary Physician/Psychiatrist (PP) presented R1 with having delusional thoughts and aggressive assaultive behavior.

R1’s PP stated during the interview that R1’s behavior was endangering self and had displayed delusional behavior and thinking. R1 had accused everyone of being against R1 and abusing R1. R1 has accused staff of installing cameras to spy on R1 and had episodes of moving furniture against R1’s bedroom door to prevent entry. R1’s primary physician stated he had no concerns “at all” of R1 being abused or “violated” at the facility.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the allegation of Personal Rights (staff inflicted injuries to resident) occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, the allegation is deemed Unsubstantiated at this time.

An exit interview was conducted, and a copy of this report will be sent to email on file.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Lydia Martinez	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023

LIC9099 (FAS) - (06/04)

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