331880733-8-21-2024-18-AS-TDAN-D8EUHL-20240823153608

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880733
Report Date: 08/21/2024
Date Signed: 08/21/2024 12:48:31 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
10/12/2021 and conducted by Evaluator Sara Martinez

COMPLAINT CONTROL NUMBER: 18-AS-20211012113203

FACILITY NAME:	FIRST CHOICE SENIOR LIVING 2		FACILITY NUMBER:	331880733
ADMINISTRATOR:	RECINTO, MONTANO O		FACILITY TYPE:	740
ADDRESS:	40147 GRENACHE CT		TELEPHONE:	(951) 239-0132
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	0	CENSUS: 0	DATE:	08/21/2024
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Montano Recinto - Administrator		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

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Licensee forced resident to go on hospice

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sara Martinez arrived unannounced to the facility to conclude the investigation into the allegation listed above. LPA met with Administrator Montano Recinto and explained the purpose of the visit. The Department’s complaint investigation consisted of interviews and records review of requested pertinent documents.

Regarding the allegation “Licensee forced resident to go on hospice”, it was reported that Licensee forced Resident One (R1) to go on hospice without their consent. Interview with Vista Hospice staff revealed an assessment was conducted with R1 and R1’s responsible party (RP) with R1’s consent. Vista Hospice staff reported they are aware of resident’s personal rights and would not force a resident on Hospice. Interview with RP revealed they were aware of R1 being put on Hospice. Interview with R1 revealed they do not remember if they were on Hospice during their stay at the facility in 2020.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara Martinez	TELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024

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 18-AS-20211012113203

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: FIRST CHOICE SENIOR LIVING 2	FACILITY NUMBER: 331880733
	VISIT DATE: 08/21/2024

NARRATIVE

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Records review of Vista Hospice Care’s assessment for R1 reveals RP’s participation in answering questions regarding R1’s health status.

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrator Recinto.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Sara Martinez	TELEPHONE: (951) 605-0913
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024

LIC9099 (FAS) - (06/04)

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