306005693-4-9-2024-22-AS-AORZ-D49P7S-20240412110422

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005693
Report Date: 04/09/2024
Date Signed: 04/09/2024 12:44:25 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
03/05/2024 and conducted by Evaluator Jenifer Tirre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240305090945

FACILITY NAME:	SILVERADO SENIOR LIVING- NEWPORT MESA		FACILITY NUMBER:	306005693
ADMINISTRATOR:	HEATHER YOUNAN		FACILITY TYPE:	740
ADDRESS:	350 W BAY STREET		TELEPHONE:	(949) 631-2212
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	82	CENSUS: 48	DATE:	04/09/2024
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Administrator Heather Younan		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff are not providing adequate care to dementia residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced subsequent visit to deliver findings for complaint investigation into the above allegations. LPA explained the reason for the visit with Administrator Heather Younan.

During the course of the investigation LPA toured facility, conducted interviews, made visual observations and requested pertinent documentation such as Personnel Report, Employee caregiver rounds, resident roster and employee listings.

During investigation LPA reviewed facility records such as Personnel report, Employee listings and Care Giver Daily rounds shift schedule dated March 11, 2024. Records reviewed revealed that Facility has 25 Caregivers, eight Licensed Vocational Nurses and two Med Tech’s who provide daily care to residents in facility. Facility records reveal that facility has three scheduled work shifts for staff, a AM shift, a PM shift and a NOC shift. CONTINUED ON 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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-20240305090945

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: SILVERADO SENIOR LIVING- NEWPORT MESA	FACILITY NUMBER: 306005693
	VISIT DATE: 04/09/2024

NARRATIVE

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Records reveal that on average facility has seven to eight Caregivers in the AM shift, five to six Caregivers in PM shift and three during NOC shift. Records also reveal that facility has on average staffing ratio of 9:1 during AM shift, 11:1 during PM shift and 17:1 during NOC shift.

LPA made the following observations during investigation; Facility is a Residential Care Facility for the Elderly that specializes in Memory care. Facility has capacity of 82. During investigation visit on 3/11/24 facility had a census of 51 and on todays date census of 48. During visit on 3/11/24, LPA observed 13 care staff assisting residents in facility. LPA observed that facility is divided into three neighborhoods for residents: Newport, Country Kitchen and Lido. During investigation it was revealed to LPA that staff are assigned to each neighborhood. During visits LPA observed residents relaxing in bedrooms watching TV, relaxing in common area dining rooms eating meals, and being assisted by staff in hallways & outside patio areas.

Interviews with staff and residents were conducted and revealed the following, seven of seven staff interviewed stated that facility has three shifts per Caregivers and that caregivers are assigned to one of three neighborhoods inside facility. Interviews with staff revealed that five of five Caregivers stated they assist residents with Activities of Daily Living (ADL’s) such as showering, toileting, making bed’s, dressing, feeding, and transporting. All staff interviewed confirmed that no residents or family members have expressed recent concerns about the quality of care provided to residents.

Interviews with Residents revealed that five of five residents stated that they had no complaints about staff members that they like the staff, staff are available when they need, and two of five residents stated that the facility is meeting their care needs. Interview with family witness confirmed that they had no issues with staffing and felt that the level of care was meeting residents needs.

Based on observations made by LPA, interviews conducted, and records 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 not providing adequate care to dementia residents is deemed UNSUBSTANTIATED.

An exit interview was conducted with Administrator Heather Younan and a copy of this report was reviewed and provided at the time of this visit.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 222-3812
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (714) 401-6844
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

LIC9099 (FAS) - (06/04)

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