331880722-4-24-2023-18-AS-JDHS-CVTU78-20230919151931

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880722
Report Date: 04/24/2023
Date Signed: 04/24/2023 12:03:11 PM

Unfounded

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
04/21/2023 and conducted by Evaluator Javina George

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230421150207

FACILITY NAME:	DESERT HILLS MEMORY CARE CENTER		FACILITY NUMBER:	331880722
ADMINISTRATOR:	HUDSON, CHANTELLE		FACILITY TYPE:	740
ADDRESS:	25818 COLUMBIA ST		TELEPHONE:	(951) 652-1837
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	58	CENSUS: 38	DATE:	04/24/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Shannon Moore, Executive Director		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Staff did not allow resident to receive phone calls

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation regarding the allegation listed above. LPA met with Shannon Moore Executive Director and Wellness Director Nathaly Ledesma, where LPA explained the purpose of the visit and elements of the allegation listed above. The allegation of staff did not allow resident to receive phone calls was investigated. The investigation consisted of observation, interviews and record review.

Regarding the allegation staff did not allow resident to receive phone calls. Resident #1 (R1) was admitted to the facility on February 27, 2023. R1 has a Power of Attorney (POA) that has indicated on the resident's release of medical information as to who the facility can and cannot give R1's healthcare information out to, as well as to take R1 out of the facility for off grounds visitation. Per the Executive Director Shannon Moore, facility staff did state that R1 was not available to the caller(s), due to R1 having been out of the community since April 18, 2023, however further information was not provided as the facility staff was unable to disclose to the callers as to the reason why, as the callers were not indicated on R1s release of medical information.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

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-20230421150207

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: DESERT HILLS MEMORY CARE CENTER	FACILITY NUMBER: 331880722
	VISIT DATE: 04/24/2023

NARRATIVE

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Upon further investigation there was an incident on Saturday April 22, 2023 where the facility staff had to contact law enforcement regarding unauthorized two (2) visitors that has refused to leave when asked, who were not screened at the gate, and entered the facility lobby demanding to see R1 and access their charts.

The Sheriff was contacted and verified that that the two visitors were not identified on R1's release of health information, and had been asked to leave and were informed that the facility staff was in fact following protocol, and had encouraged the visitors to follow up with R1's POA. Based on observation, interviews, and record review the allegation of staff did not allow resident to receive phone call is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Therefore, the department had there dismissed the complaint.

An exit interview was conducted, and a copy of this report was provided to Executive Director Shannon Moore.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

LIC9099 (FAS) - (06/04)

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