306004582-3-21-2023-22-AS-SSAS-CQD2QM-20230328173607

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004582
Report Date: 03/21/2023
Date Signed: 03/21/2023 11:54:01 AM

Unfounded

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
03/14/2023 and conducted by Evaluator Patricia Velazquez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230314160217

FACILITY NAME:	VIVANTE ON THE COAST		FACILITY NUMBER:	306004582
ADMINISTRATOR:	ROBERT FIORENTINO II		FACILITY TYPE:	740
ADDRESS:	1640 & 1650 MONROVIA AVE		TELEPHONE:	(949) 629-2100
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	430	CENSUS: 322	DATE:	03/21/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Bob Fiorentino - Senior Executive Director		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Unlawful eviction

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced initial 10 day complaint visit to initiate the investigation into the above allegation. LPA Velazquez was allowed entry into the facility and met with Senior Executive Director (SED) Bob Fiorentino and explained the purpose of the visit.

On today's visit LPA Velazquez conducted interviews with staff. At 11:02 AM LPA Velazquez along with Health Services Director (HSD) Deisi Lujan, L.V.N. went to check in on Resident (R) #1 who was sleeping in their bed. R1 was briefly aroused awake but fell right back to sleep. LPA and HSD departed R1's room to allow resident to continue sleeping. LPA also reviewed and requested copies of pertinent documents from R1's file. During the course of the investigation the following was revealed. LPA Velazquez reviewed R1's records as well as conducted interviews with staff. The records reviewed included Hoag Memorial Hospital Newport Emergency Center medical records which included a Psychiatric Evaluation conducted on February 16, 2023. The following records from Chapman Global Medical Center were reviewed: Progress Note Inquiry, Medication Reconciliation

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia Velazquez	TELEPHONE: (949) 236-0556
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 22-AS-20230314160217

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: VIVANTE ON THE COAST	FACILITY NUMBER: 306004582
	VISIT DATE: 03/21/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Order Report, Application for Assessment, Evaluation and Crisis Intervention or Placement for Evaluation and Treatment, and Writ of Habeus Corpus hearing results dated March 13, 2023 legally granting R1 release from Chapman Global Medical Center.

R1 was initially admitted to Vivante on the Coast on September 30, 2022. R1 was sent out from the facility to Hoag Memorial Hospital Newport via a 911 call on February 15, 2023. R1 was subsequently admitted to the hospital and then transferred to Chapman Global Medical Center on February 16, 2023 for further psychiatric evaluation and treatment. R1 remained at Chapman Global Medical Center until March 13, 2023 when a Writ of Habeus Corpus hearing was held. The Orange County Court granted the Writ of Habeus Corpus for R1 allowing R1 to be released from the hospital back to Vivante on the Coast. Vivante of the Coast worked with the Council on Aging - Southern California Long Term Care Ombudsman and R1 was readmitted back to the facility on March 14, 2023 where they are currently residing. Two of two individuals interviewed confirmed R1 was readmitted back to Vivante on the Coast and R1 was never formally issued a written eviction notice nor formally evicted from the facility.

This agency has investigated the complaint and based on the observations made by LPA Patricia Velazquez, interviews which were conducted and the records that were reviewed, the following allegation: Unlawful eviction is deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

LPA Velazquez reviewed Title 22 Regulation Section 87224 titled Eviction Procedures with SED Fiorentino who acknowledged receiving a copy of said regulation at the time of this visit.

An exit interview was conducted with Senior Executive Director Bob Fiorentino and a copy of this report along with the LIC 811 were provided at the time of this visit.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia Velazquez	TELEPHONE: (949) 236-0556
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2