330910554-7-1-2020-18-AS-RLAY-BRBTL2-20200708144845

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 330910554
Report Date: 06/24/2020
Date Signed: 07/01/2020 04:52:04 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/27/2020 and conducted by Evaluator Pauline Beschorner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200527125735

FACILITY NAME:	PARADISE GUEST RANCH		FACILITY NUMBER:	330910554
ADMINISTRATOR:	VASQUEZ, CONNIE		FACILITY TYPE:	740
ADDRESS:	19150 KRIS ROAD		TELEPHONE:	(760) 329-8905
CITY:	SKY VALLEY	STATE: CA	ZIP CODE:	92241
CAPACITY:	6	CENSUS: 5	DATE:	06/24/2020
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Connie Vasquez		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility staff do not respond when resident needs assistance
Facility staff do not ensure residents are treated with dignity
Facility staff do not meet residents care needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pauline Beschorner conducted this investigation visit telephonically due to Covid-19 to conclude this agency’s investigation into the complaint allegations mentioned above. LPA spoke with Administrator Connie Vasquez.

During this investigation, interviews were conducted with two (2) staff (S1 and S2), one (1) resident and three (3) witnesses (W1, W2, W3). A review of resident (R1) records was completed by LPA and copies of pertinent documents were obtained. LPA reviewed R1's physician's report and needs and service plan. LPA also reviewed staff trainings provided to S1 and S2.

It is alleged that facility staff do not respond when resident needs assistance and facility staff do not ensure that residents are treated with dignity. Based on interviews with R1, W1and W2 LPA learned the following:

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Pauline Beschorner	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2020

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 18-AS-20200527125735

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PARADISE GUEST RANCH	FACILITY NUMBER: 330910554
	VISIT DATE: 06/24/2020

NARRATIVE

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When a resident needs assistance staff are very attentive to residents needs and immediately assist residents in care. R1 stated that R1 “loves it at this facility because it feels like home.” R1 feels well taken care of. W2 stated that R2 is well cared for. W2 also stated that R2 is clean, well groomed, clothes are washed and R2 has even gained weight. Interviews conducted did not corroborate the allegation that facility staff do not respond when resident needs assistance or that staff do not ensure residents are treated with dignity.

It is alleged that facility staff do not meet residents care needs. Based on record review of S1 and S2 training documents and interviews with R1 and W1 the care needs of R1 are being met. S1 and S2 have received appropriate training to meet the care needs of the residents and R1 and W1 state that the staff are very attentive to resident’s care needs.

We have found the complaint allegations to be unfounded, meaning that the allegations were false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

A copy of this report is being reviewed with and furnished to the facility Administrator Connie Vasquez via email.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Pauline Beschorner	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2020

LIC9099 (FAS) - (06/04)

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