331881115-8-16-2022-18-AS-JESL-CJPW5P-20220928165929

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881115
Report Date: 08/16/2022
Date Signed: 08/16/2022 03:32:40 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
08/08/2022 and conducted by Evaluator Crystal Colvin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220808094412

FACILITY NAME:	ANGEL'S LOVING TOUCH		FACILITY NUMBER:	331881115
ADMINISTRATOR:	CERDA, YAZMIN S.		FACILITY TYPE:	740
ADDRESS:	37212 EDGEMONT DRIVE		TELEPHONE:	(951) 249-9041
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	6	CENSUS: 4	DATE:	08/16/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Yazmin Cedra - Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Facility refused to provide a refund

Facility did not accept back resident into care

INVESTIGATION FINDINGS:

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On today's date, Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of initiating an investigation with the above allegation. LPAs Colvin met with Administrator Yazmin Cedra. Below is a summary of the findings of the investigation:

Regarding allegation "Facility refused to provide a refund": LPA Colvin reviewed the facility's Admissions Agreement for a prior resident (R1) including added optional services. LPA Colvin observed that R1's monthly expenses for July 2022 was paid in full, prior to R1 being sent out to the hospital. On July 13,2022, R1's Power of Attorney (POA) submitted notice that R1 would not be returning to the facility. R1's POA requested a refund under the section of the Admissions Agreement which states that only a 14 day notice is required (in lieu of a 30-day notice) if the resident is in the hospital with a Prohibited Health Condition. R1 was hospitalized for COVID-19, which is not considered a Prohibited Health Condition (diagnosis' meeting this criteria can be located in Title 22 Regulation Section 87615). Therefore, R1's POA was still responsible for a 30-day notice for R1, which would be from July 13, 2022 to August 12, 2022. Administrator Yazmin Cedra provided LPA Colvin

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

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-20220808094412

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: ANGEL'S LOVING TOUCH	FACILITY NUMBER: 331881115
	VISIT DATE: 08/16/2022

NARRATIVE

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with a copy of an invoice sent to R1's POA showing that no further charges would be requested from the facility past what was already paid for the month of July 2022. Therefore, based on record review and interviews conducted, the allegation "Facility refused to provide a refund" is UNSUBSTANTIATED, as there is not enough evidence to suggest that the facility owed R1's POA a refund.

Regarding allegation "Facility did not accept back resident into care": LPA Colvin conducted interviews with Administrator Yazmin Cedra and others with knowledge of R1's relocation from the facility to the hospital, and R1 subsequently not returning to the facility. All interviews conducted confirmed that there was concern regarding R1 being positive for COVID-19 and having Dementia, and therefore having difficulty with isolation. LPA Colvin was unable to verify the reason for R1 not returning to the facility when R1 was ready to be discharged from the hospital, as interviews conflicted on if the facility was requiring R1's POA to provide/pay for additional care/services. Administrator Yazmin Cedra confirmed that there was a conversation regarding needing additional staff to supervise R1 during R1's quarantine period (if returning to the facility), but the Administrator states that specifics were never discussed (such as if there would be additional charges), as R1's POA elected to have R1 discharged back to home with family without prior collaboration with Administrator. Yazmin Cedra remained adamant that R1 was never declined returning to the facility from the hospital while positive with COVID-19, and that Yazmin Cedra simply discussed the difficulties this may pose and the different aspects that the family should consider. Therefore, due to lack of evidence and conflicting interviews, the allegation "Facility did not accept back resident into care" is UNSUBSTANTIATED.

A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted with Administrator Yazmin Cedra and a copy of this report was provided.

SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

LIC9099 (FAS) - (06/04)

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