306005693-4-6-2023-22-AS-SSAS-CRNUHS-20230509153622

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005693
Report Date: 04/06/2023
Date Signed: 04/06/2023 12:08:45 PM

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
10/04/2022 and conducted by Evaluator Patricia Velazquez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20221004151007

FACILITY NAME:	SILVERADO SENIOR LIVING- NEWPORT MESA		FACILITY NUMBER:	306005693
ADMINISTRATOR:	MICHAEL MARION		FACILITY TYPE:	740
ADDRESS:	350 W BAY STREET		TELEPHONE:	(949) 631-2212
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	82	CENSUS: 58	DATE:	04/06/2023
		UNANNOUNCED	TIME BEGAN:	08:48 AM
MET WITH:	Heather Younan - Administrator		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Staff are falsifying residents' medical records
Staff did not safeguard resident's personal belongings

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Patricia Velazquez conducted a subsequent complaint visit to deliver the findings of the investigation into the above allegations. LPA Velazquez was allowed entry into the facility and initially met with Business Office Coordinator Yesenia Avelar-Cartagena. Administrator Heather Younan arrived later to assist LPA with the visit.

On today's visit LPA Velazquez conducted interviews with residents and staff. LPA Velazquez also requested and obtained copies of facility, resident, and staff records. During the course of the investigation the following was revealed: LPA Velazquez conducted interviews with residents and staff. LPA Velazquez also reviewed facility, resident, and staff records. The records reviewed included Resident Identification and Emergency Information, Preplacement Appraisal Information, Physician's Reports, Inventory Sheets documenting a resident's personal belongings and Service Plans. Ten of ten individuals interviewed provided conflicting statements and could not corroborate the above allegations. Staff interviewed described the process how a

Unsubstantiated

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: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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-20221004151007

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: SILVERADO SENIOR LIVING- NEWPORT MESA	FACILITY NUMBER: 306005693
	VISIT DATE: 04/06/2023

NARRATIVE

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resident's hearing aids are safeguarded. Staff will check out the hearing aids in the morning and assist residents with placing the hearing aids in their ears. The PM staff then remove the hearing aids when residents are going to sleep and are checked and logged in, placed in chargers, and locked in the medication room.

The facility cares for residents with Dementia and it is the facility's policy to keep all residents' rooms open and unlocked. Some residents tend to wander into other resident rooms where they may take something that does not belong to them. Facility staff redirect those residents and then obtain any items taken and return them to their rightful owner. Per staff, some residents remove their hearing aids because they do not want to wear them and may misplace them but they are usually found.

Based on the observations made by LPA Patricia Velazquez, interviews which were conducted and the records that were reviewed, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the following allegations: Staff are falsifying residents' medical records and Staff did not safeguard resident's personal belongings are deemed UNSUBSTANTIATED.

An exit interview was conducted with Administrator Heather Younan and Health Services Director Ashley Guerra, R.N. and a copy of this report was provided at the time of this visit. Due to technical difficulties LPA Velazquez was not able to print the report at the time of the visit. Administrator Younan agreed to receive the report via email.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia Velazquez	TELEPHONE: (949) 236-0556
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC9099 (FAS) - (06/04)

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