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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426745
Report Date: 11/09/2022
Date Signed: 11/09/2022 09:37:42 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
03/08/2022 and conducted by Evaluator Jesse Gardner
COMPLAINT CONTROL NUMBER: 18-AS-20220308120737
FACILITY NAME:MATTHIAS HOMEFACILITY NUMBER:
336426745
ADMINISTRATOR:JAMES TOLANDFACILITY TYPE:
735
ADDRESS:13801 MOUNTAIN TOP DRIVETELEPHONE:
(760) 671-7421
CITY:DESERT HOT SPRINGSSTATE: CAZIP CODE:
92240
CAPACITY:6CENSUS: 5DATE:
11/09/2022
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Carolina Horigan, CaregiverTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Client had to be hospitalized while in care
Staff did not seek timely medical attention for a client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to the facility to deliver findings for the above allegations. LPA met with Caregiver Carolina Horigan and toured the facility. The Department investigation involved interviews with staff, resident (R1) and a review of R1’s medical records.

An allegation received stated resident was hospitalized while in care due to staff neglect. The Department’s investigation revealed Resident One (R1) was taken to the hospital on 2/28/22 due to pain. R1 was provided a medicated shot for the discomfort, prescribed Ibuprofen and advised to follow-up with their specialist. *Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
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 2
Control Number 18-AS-20220308120737
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: MATTHIAS HOME
FACILITY NUMBER: 336426745
VISIT DATE: 11/09/2022
NARRATIVE
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Per hospital discharge instructions, R1 was “stable for discharge.” On 3/3/22, R1 was seen by a specialist and prescribed additional medications to treat the condition. On 3/3/22, R1 complained of continuing pain and was taken to the hospital that same day. Information obtained during the investigation provided confirmation that R1 was being provided medical treatment; however, the investigation could not corroborate the allegation that R1 was hospitalized while in care due to staff neglect.

A second allegation received stated staff did not seek timely medical care for R1. The investigation revealed R1 had been experiencing pain on 2/28/22 and was taken to the hospital for treatment. R1 was prescribed Ibuprofen and referred to a specialist for additional follow up. On 3/2/22, R1 had a follow up appointment with the specialist and was prescribed additional medications.

The following day, 3/3/22, R1 continued to experience pain and was taken to the hospital sometime in the evening. An interview with the House Manager revealed R1 had complained of pain earlier in the day, was advised to give the medication time to work and was told if the pain didn’t get better, R1 would be taken to the hospital. Approximately 5 hours later, when the pain had not subsided, R1 was taken to the hospital. Additional information obtained through confidential witness asserted staff refused to take R1 to the hospital. The witness contacted staff and instructed them to take R1 to the hospital. Witness interviews confirmed R1 was in fact taken to the hospital on 3/3/22, the same day R1 complained of pain.

Therefore, based on the investigation the allegations "Client had to be hospitalized while in care" and , "Staff did not seek timely medical attention for a client", are UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was discussed with and provided to Caregiver Briana Bryant.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2