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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331881263
Report Date: 02/07/2025
Date Signed: 02/07/2025 01:35:18 PM

Substantiated


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
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/04/2025 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250204155439
FACILITY NAME:WE CARE LIVINGFACILITY NUMBER:
331881263
ADMINISTRATOR:DIMAURO, DAVIDFACILITY TYPE:
735
ADDRESS:31894 SILK VINE DRTELEPHONE:
(951) 501-6473
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY:4CENSUS: 4DATE:
02/07/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH: David DiMauro Sr.TIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Staff mismanaged client's medication.
INVESTIGATION FINDINGS:
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On 02/07/2025 at 08:45 AM, Licensing Program Analyst (LPA) Melody Brown arrived unannounced at the facility to commence and deliver the findings of a complaint investigation. LPA was greeted and granted entrance by Staff #2 (S2) and met with Licensee/Administrator David DiMauro Jr. LPA Brown identified herself and discussed the purpose of the visit and the elements of the allegation with Licensee/Administrator Di Mauro Jr.

LPA Brown conducted a quick tour of the facility, interviews with resident and staff and obtained and reviewed facility records. The investigation was conducted by LPA Melody Brown. The investigation consisted of records review and interviews with relevant parties. The allegation indicates that staff mismanaged client's medication. During the investigation, LPA Brown obtained evidence to corroborate the allegation. Interview with Client #1 (C1) confirmed that C1 did not take one (1) of C1's medication as prescribed by C1's doctor on 01/29/2025 until C1's one (1) medication issue was adressed on 02/03/2025. ***Cont. in LIC9099C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 56-AS-20250204155439
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
, CA 92507
FACILITY NAME: WE CARE LIVING
FACILITY NUMBER: 331881263
VISIT DATE: 02/07/2025
NARRATIVE
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During the facility visit today, 02/07/2025, Staff #1 (S1) confirmed to LPA Brown that one (1) of C1's medication was not given to C1 from 01/29/2025 to 02/02/2025 due to issues with C1's family member. Moreover, S1 informed LPA Brown that C1 was given the required medication on 02/03/2025 when they went to C1's family member's home to obtain one (1) of C1's medication. C1's Medication Administration Record (MAR) review indicated that C1 was not given one (1) medication per C1's doctor from 01/29/2025 to 02/02/2025.

Based on LPA Brown’s observations, interviews and records review, the preponderance of evidence standard has been met, and therefore the above allegation of staff mismanaged client's medication is found to be SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. California Code of Regulations, (Title 22, Division 6 & Chapter 6) is being cited on the attached LIC9099D.

An exit interview was conducted where this report (LIC9099), LIC9099D, and Appeal Rights were discussed and provided to staff David Di Mauro Sr.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20250204155439
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
, CA 92507

FACILITY NAME: WE CARE LIVING
FACILITY NUMBER: 331881263
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/08/2025
Section Cited
CCR
80075(b)
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80075 Health Related Services (b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications.
This requirement was not met as evidenced by:
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Licensee stated to train all staff on CCR 80075(b) and submit proof of staff training log to LPA Brown by the Plan of Correction (POC) due date.
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Based on observation, interview and records review, the Licensee did not comply with the section cited above by not ensuring that staffs at the facility are assisting Client #1 (C1) with one (1) medication as prescribed by C1's physician from 01/29/2025 to 02/02/2025 which poses an immediate health, safety and personal rights risk to client in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3