336423909-4-5-2024-18-AS-JDHS-D6BLBP-20240617083701

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336423909
Report Date: 04/05/2024
Date Signed: 04/05/2024 09:34:12 AM

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
10/19/2023 and conducted by Evaluator Yolanda Delgado

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20231019131403

FACILITY NAME:	CAMPBELL'S LOVING HOME CARE INC.		FACILITY NUMBER:	336423909
ADMINISTRATOR:	CHARLES CAMPBELL		FACILITY TYPE:	740
ADDRESS:	18 NAPOLEON RD.		TELEPHONE:	(760) 832-7791
CITY:	RANCHO MIRAGE	STATE: CA	ZIP CODE:	92270
CAPACITY:	6	CENSUS: 3	DATE:	04/05/2024
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Charles Campbell, Licensee		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Resident is being financially abused while in care
Resident is being neglected while in care
Resident is being isolated while in care
Resident’s personal rights are being violated while in care
Resident was left without oxygen for 30 minutes while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to the facility to conclude an investigation into the allegations listed above. LPA met with Charles Campbell and explained the purpose of the visit. During the course of the investigation, records were reviewed, and interviews were conducted with facility staff members, residents, and witnesses.

On October 19, 2023, Community Care Licensing received a complaint alleging that resident is being financially abused while in care, resident is being neglected while in care, resident is being isolated while in care, resident’ personal rights are being violated while in care, resident was left without oxygen for 30 minutes while in care.

(Continued on page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Yolanda Delgado	TELEPHONE: (951) 203-2990
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

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-20231019131403

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: CAMPBELL'S LOVING HOME CARE INC.	FACILITY NUMBER: 336423909
	VISIT DATE: 04/05/2024

NARRATIVE

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(Continued from page 1)

In regard to the allegation that Resident is being financially abused while in care, facility records revealed Resident #1 (R1) did not need assistance in managing their cash resources and managed their own finances. It was also documented that R1 has a Power of Attorney (POA). Information obtained from interviews with R1 indicated that there were no concerns and denied being financially abused. Interviews with staff denied that R1 was being financially abused while in care.

Regarding allegation that Resident is being neglected while in care, facility records revealed that R1 was under the care of a hospice agency. Hospice agency staff observed R1 conducted body inspections weekly and reviewed medications. Interview with R1 denied that R1 was being neglected. Interviews with staff denied that R1 was being neglected while in care.

Regarding allegation “Resident is being isolated while in care”. Records were reviewed and interviews were conducted with facility staff members, RCFE residents and witnesses. The Facility records revealed that R1 received visits from visitors, was under Hospice care and was seen on a weekly basis. Interviews with staff and witnesses revealed that R1 communicated with staff and witnesses.

Regarding the allegation “Resident’s personal rights are being violated while in care”. Records were reviewed, and interviews were conducted with facility staff members, RCFE residents and witnesses. The Facility records revealed that R1 had no personal rights were violated. Interview with R1 denied that R1’s personal rights were being violated.

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SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Yolanda Delgado	TELEPHONE: (951) 203-2990
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20231019131403

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: CAMPBELL'S LOVING HOME CARE INC.	FACILITY NUMBER: 336423909
	VISIT DATE: 04/05/2024

NARRATIVE

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(Continued from page 2)

Regarding the allegation “Resident was left without oxygen for 30 minutes while in care”. Records were reviewed, and interviews were conducted with facility staff members, RCFE residents and witnesses. The Facility records revealed that R1 used oxygen as needed and was able to administer handheld nebulizer. Interview with R1 denied that R1 was left without oxygen for 30 minutes.

Therefore, the allegations of resident is being financially abused while in care, resident is being neglected while in care, resident is being isolated while in care, resident’ personal rights are being violated while in care, and resident was left without oxygen for 30 minutes while in care is Unsubstantiated. Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

An exit interview was conducted with Charles Campbell and a copy of this report along with LIC811- Confidential Names list was provided.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Yolanda Delgado	TELEPHONE: (951) 203-2990
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC9099 (FAS) - (06/04)

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