331800103-9-8-2021-18-AS-DMUN-C9CT56-20211203132455

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800103
Report Date: 09/08/2021
Date Signed: 09/08/2021 01:55:37 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
03/11/2021 and conducted by Evaluator Tricia Danielson

COMPLAINT CONTROL NUMBER: 18-AS-20210311103931

FACILITY NAME:	LEGEND GARDENS		FACILITY NUMBER:	331800103
ADMINISTRATOR:	PENDING		FACILITY TYPE:	740
ADDRESS:	73685 CATALINA WAY		TELEPHONE:	(760) 773-3115
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92260
CAPACITY:	96	CENSUS: 37	DATE:	09/08/2021
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Carrie MacDonald, Community Relations Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility does not have an administrator.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tricia Danielson arrived to the facility unannounce to conclude a complaint investigation into the allegation listed above. LPA met with Community Resourses Director (CRD) Carrie MacDonald who is acting as the facility's Administrator due to the absence of an official Administrator.

During today's visit, LPAs interviewed CRD who reported the facility is without an Administrator at this time due to the recent departure of the facility's interim management company, Northstar. CRD reported she has received no contact from the Licensee regarding a temporary Administrator. CRD has taken it upon herself to act as the Administrator for the time being.
Based on LPAs observations, interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code Of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099 D.
An exit interview was conducted with CRD MacDonald and a copy of this report was provided along with Appeal Rights. Community Care Licensing (CCL) will send a certified copy along with emailed copies of this report, LIC809D, and Appeal Rights to Licensee.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Reyna Lacey	TELEPHONE: (951) 836-3135
LICENSING EVALUATOR NAME: Tricia Danielson	TELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

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-20210311103931

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: LEGEND GARDENS	FACILITY NUMBER: 331800103
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/08/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/16/2021 Section Cited CCR 87405(a)	1 2 3 4 5 6 7	Administrator Qualifications and Duties- (a) All facilities shall have a qualified and currently certified administrator...The administrator...shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility...there shall be coverage by a designated substitute...	1 2 3 4 5 6 7	Due to the lack of an Administrator and Licensee's participation, LPA and CRD developed the POC. The Licensee will appoint an Administrator or submit a plan with a deadline to hire an Administrator by POC due date. CRD has agreed to notify Licensee of this POC.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on LPA observations and interview conducted, the facility does not have an Administrator. This poses an potential threat to the health, safety, and person rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Reyna Lacey	TELEPHONE: (951) 836-3135
LICENSING EVALUATOR NAME: Tricia Danielson	TELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

LIC9099 (FAS) - (06/04)

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