336426330-7-18-2023-18-AS-JESL-CV7TVT-20230830150428

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336426330
Report Date: 07/18/2023
Date Signed: 07/18/2023 04:24:42 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
07/17/2023 and conducted by Evaluator Javina George

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230717081614

FACILITY NAME:	VISTA MONTANA SENIOR LIVING		FACILITY NUMBER:	336426330
ADMINISTRATOR:	MARYANN KANEKOA		FACILITY TYPE:	740
ADDRESS:	155 N. GIRARD ST.		TELEPHONE:	(951) 658-2274
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	120	CENSUS: 77	DATE:	07/18/2023
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Maryann Kanekoa		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are retaliating against resident in care.
Staff do not safeguard resident's personal belongings.
Resident has access to marijuana.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation in regards to th allegation(s) listed above. LPA met with Administrator Maryann Kanenoa and explained the purpose of the visit and the elements of the allegations. The allegations were investigated.The investigation consisted of observations, interviews and record review.

Regarding the allegation of staff are retaliating against resident in care.
Based on an interview with the Executive Director Maryann Kanekoa there are three (3) residents that were been issued an eviction notice within the last 30 days. However there is one resident Resident #1 (R1) that asked Maryann if she "wanted a war", and stated "game on". It is believed that this why there is the allegation, however specific examples were not provided. Due to lack of evidence LPA was unable to corroborate the allegation retaliating against resident in care is UNSUBSTANTIATED.

***Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

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 4

Control Number 18-AS-20230717081614

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: VISTA MONTANA SENIOR LIVING	FACILITY NUMBER: 336426330
	VISIT DATE: 07/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Staff do not safeguard resident's personal belongings
Regarding the allegation staff do not safeguard resident's personal belongings. Per Executive Director
Maryann R1 is the only resident to come forward to report that they have had items come up missing. R1 sent an email dated 6/23/23 with a list of items: such as plastic cups, a cell phone belonging to another resident, insulated coffee cup, toe nail clipper, DVD remote, metal forks and knives, key chains, DVD's and CD's. However per R1's personal inventory sheet none of the items reported missing are not indicated on the inventory sheet. The facility was not aware that R1 had such items. Per the facility's furnishings and personal belongings policy "Vista Montana cannot be responsible for money, jewelry or any loss of valuables. Residents are encouraged to lock their rooms and should only keep a minimum of $20.00 cash in their possession". Based on a record review the allegation of facility Staff do not safeguard resident's personal belongings is UNSUBSTANTIATED.

Resident has access to marijuana
Per the Executive Director Maryanne Kanekoa there are multiple residents that do smoke on the property, the smoking does include marijuana. Smoking is permitted at the facility. Further, there is not a list that is kept of the residents that do smoke marijuana. If the resident does choose to smoke they are permitted to do so in accordance to facility policy. Which states that smoking of any kind is to be done so in the designated smoking areas (outside in the front, and on the side of the building.) If it is marijuana then the only area designated is under the gazebo. Per Maryann recreational marijuana usage is legal and that it is permitted, however smoking is to be done outside in the gazebo area only. Ms. Maryann does not have any record or report of anyone at the facility attempting to sell or distribute marijuana. The allegation of resident has access to marijuana is UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.

An exit interview was conducted and a copy of this report was provided to Maryann Kanekoa, Executive Director.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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
07/17/2023 and conducted by Evaluator Javina George

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230717081614

FACILITY NAME:	VISTA MONTANA SENIOR LIVING		FACILITY NUMBER:	336426330
ADMINISTRATOR:	MARYANN KANEKOA		FACILITY TYPE:	740
ADDRESS:	155 N. GIRARD ST.		TELEPHONE:	(951) 658-2274
CITY:	HEMET	STATE: CA	ZIP CODE:	92544
CAPACITY:	120	CENSUS: 77	DATE:	07/18/2023
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Maryann Kanekoa		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Illegal eviction

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation in regards to th allegation listed above. LPA met with Administrator Maryann Kanenoa and explained the purpose of the visit and the elements of the allegation. The allegations were investigated.The investigation consisted of observations, interviews and record review.

Reagrding the allegation Illegal eviction

Based on an interview with the Executive Director Maryann Kanekoa there are three (3) residents that were issued an eviction notice within the last 30 days. Resident #1 (R1) was issued a 30 day eviction notice on 7/12/23 due to R1 being delinquent on their base daily rent and personal care daily rate for the amount $6,750.. In addition to violation of resident rights: #4. "Such as to be granted a reasonable level of personal privacy in accommodations visits, communications and meetings of resident and family groups.
**Continued on 9099C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 18-AS-20230717081614

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: VISTA MONTANA SENIOR LIVING	FACILITY NUMBER: 336426330
	VISIT DATE: 07/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

R1 was reported and observed to have been going around the facility and acting as a state certified Doctor for the community, further incidences include distributing medication to another resident. Based on interviews and record review the allegation of illegal eviction is UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was provided to Maryann Kanekoa, Executive Director.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Javina George	TELEPHONE: (951) 204-7107
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4