336426054-8-4-2021-18-AS-NBRN-C8LPNC-20211109102745

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426054
Report Date: 08/04/2021
Date Signed: 08/04/2021 01:46:04 PM

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
04/13/2021 and conducted by Evaluator Shaunte Henry

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20210413091720

FACILITY NAME:	CALEO BAY ALZHEIMER'S SPECIAL CARE CENTER		FACILITY NUMBER:	336426054
ADMINISTRATOR:	WILKIN, RONDA		FACILITY TYPE:	740
ADDRESS:	47805 CALEO BAY DRIVE		TELEPHONE:	(760) 771-6100
CITY:	LA QUINTA	STATE: CA	ZIP CODE:	92253
CAPACITY:	66	CENSUS: 63	DATE:	08/04/2021
		UNANNOUNCED	TIME BEGAN:	12:49 PM
MET WITH:	Fanny Villalobos, Home Service Coordinator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Resident not allowed visitations.
Resident not allowed incoming or outgoing phone calls.
Resident is not given telephone privacy.
Staff not allowing resident to speak with Ombudsman.
Resident is not provided a proper bed.
Facility staff is not providing adequate activities for the resident(s)

INVESTIGATION FINDINGS:

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On 8/4/21 Licensing Program Analysts (LPA)s Shaunte Henry and Anna Bueno conducted an unannounced visit for the purpose of delivering the findings to the above allegations. The LPAs met Fanny Villalobos explained the nature of the visit and were granted entry. LPA Henry spoke to Executive Director Heather Myers via phone.

An interview with Resident 1's (R1)s Power of Attorney revealed that R1 is allowed visitation; is allowed incoming and outgoing calls; is given telephone privacy; is allowed to speak to an Ombudsman; has a proper bed; and has access to adequate activities. An interview with R1 confirmed that all 6 allegations are false. The ED denied all 6 allegations. This agency has investigated the complaint allegation. We have found that the complaint was UNFOUNDED meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted where this report was provided to Fanny Villalobos.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Nedra Brown	TELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte Henry	TELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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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