331800114-3-27-2023-18-AS-JESL-CS7ST6-20230526140902

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331800114
Report Date: 03/27/2023
Date Signed: 03/27/2023 01:19:38 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, 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
09/09/2020 and conducted by Evaluator Jesse Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200909113611

FACILITY NAME:	VINEYARD RANCH AT TEMECULA		FACILITY NUMBER:	331800114
ADMINISTRATOR:	GREGORY CASE		FACILITY TYPE:	740
ADDRESS:	27350 NICOLAS RD		TELEPHONE:	(951) 308-1988
CITY:	TEMECULA	STATE: CA	ZIP CODE:	92591
CAPACITY:	0	CENSUS: 0	DATE:	03/27/2023
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Kurt Knauer, Administrator		TIME COMPLETED:	01:25 PM

ALLEGATION(S):

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Facility staff are not properly disposing medications
Resident wandered away from the facility
Facility staff is not dispensing medications as prescribed
Facility staff allowed memory care resident to leave the facility unsupervised

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jesse Gardner arrived unannounced to deliver findings to an investigation into the allegations listed above. LPA met with Administrator Kurt Knauer and explained the purpose of the visit. LPA later during the tour of the facility.

It was alleged that the facility was not in compliance with its medication destruction policy. Both med rooms were allegedly full of discontinued meds, expired meds, and from residents who have passed away. Discontinued narcotics have also allegedly not been destroyed. Through interviews with staff, LPA discovered that the primary staff person who’s responsibility was the destruction of medication had passed away, and the facility had not continued their duties for approximately 2 months, before hiring a new medical tech. Staff interviews revealed that when the medical tech was hired, disposing of the medications was a large job; however, a record was being maintained for the destruction of medications. Therefore, there was not preponderance of evidence to conclude that the violation did or did not occur. Thus, this allegation was Unsubstantiated.

Continued on LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse Gardner	TELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

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 18-AS-20200909113611

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: VINEYARD RANCH AT TEMECULA	FACILITY NUMBER: 331800114
	VISIT DATE: 03/27/2023

NARRATIVE

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It was alleged that on 9/8/2020 at about 5:15am, an assisted living resident was found outside in front of the building by the facility’s sign. Through several staff interviews that were conducted, a resident had not been seen or known to be outside of the facility without supervision. Due to lack of evidence, this allegation was Unsubstantiated.

It was alleged that residents complain of not receiving meds or they believe they are given the wrong meds. Through interviews conducted with staff, and residents, LPA discovered that there is not enough evidence to prove that residents had not received their medications, or other resident medications. Therefore, this allegation was Unsubstantiated.

It was alleged that staff allowed memory care resident to leave the facility unsupervised. Further, the Executive Director (ED) Gregory Case allegedly approved Resident One (R1) who was in memory care to leave the community alone in an uber. Interviews with ED revealed that R1’s wife had sent an uber to come and pick R1 up, but ED interrupted the situation and did not let R1 leave in the uber. ED stated that they called R1's wife and said they could not let R1 leave in an uber due to his cognitive abilities. Due to lack of evidence, and conflicting accounts, this allegation was Unsubstantiated.

An exit interview was conducted where a copy of this report was discussed with and provided.

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse Gardner	TELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

LIC9099 (FAS) - (06/04)

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