361880801-5-22-2023-56-AS-KCLS-CS4UQZ-20230523154758

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880801
Report Date: 07/12/2022
Date Signed: 05/22/2023 11:28:08 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
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/07/2022 and conducted by Evaluator Javier Prieto

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20220707091011

FACILITY NAME:	JASMIN TERRACE AT YUCCA VALLEY		FACILITY NUMBER:	361880801
ADMINISTRATOR:	MICHAEL GARCIA		FACILITY TYPE:	740
ADDRESS:	55425 SANTA FE TRAIL		TELEPHONE:	(760) 365-0887
CITY:	YUCCA VALLEY	STATE: CA	ZIP CODE:	92284
CAPACITY:	85	CENSUS: 73	DATE:	07/12/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Executive Director, Michael Garcia		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff engaged in inappropriate interactions with other staff members in the presence of residents
Staff did not treat residents with dignity and respect
Staff member smokes marijuana on the premises in the presence of residents
Staff did not administer medication as prescribed
Staff did not provide a comfortable environment for residents in care
Uncleared staff on the premises

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above named allegations. LPA Prieto met with Director Garcia to discuss the element of the allegations. Garcia states the staff #1 (S1), in question, has not been employed that this facility for some time, and not available for questioning relating to the allegations. Garcia does state, though, that he is not aware of S1 engaging in inappropriate interactions with other staff in the presence of residents or that S1 treated residents without dignity or respect. Garcia states that there is no knowledge of S1 returning to the facility to smoke marijuana in the presence of residents. There was no specific information pertaining S1 not administering medications as prescribed, during S1s employment at the facility, or being rude to any residents in care and making their environment uncomfortable. Garcia states that, alleged uncleared, staff #2 (S2) is not employed at this facility. Garcia clarified that S1 and S2 are not currently employed at this facility nor are they volunteers returning or visiting this facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

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 56-AS-20220707091011

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: JASMIN TERRACE AT YUCCA VALLEY	FACILITY NUMBER: 361880801
	VISIT DATE: 07/12/2022

NARRATIVE

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Staff #3 (S3) interviewed is not aware of any staff or resident's smoking marijuana at the facility, staff not treating residents dignity, or any other inappropriate behaviors by staff in the presence of residents nor providing an uncomfortable environment. Staff #4 (S4) interviewed is not aware of any staff or resident's smoking marijuana at the facility, staff not treating residents dignity, or any other inappropriate behaviors by staff in the presence of residents nor providing an uncomfortable environment. S4 explained medication dispensing procedures and cannot conclude that medications are not being dispensed appropriately. Staff #5 (S5) interviewed is not aware of any staff or resident's smoking marijuana at the facility, staff not treating residents dignity, or any other inappropriate behaviors by staff in the presence of residents nor providing an uncomfortable environment. S5 explained medication dispensing procedures and cannot conclude that medications are not being dispensed appropriately.

Residents #1 (R1), (R2), (R3), (R4), (R5), were interviewed and the consensus of those interviews could not conclude that they observed any staff engaging in inappropriate activity, smoking marijuana at the facility by staff, treating residents without dignity, or making the environment uncomfortable.

Based on the information obtained there is not enough evidence that staff engaged in inappropriate interactions with other staff members in the presence of residents, staff did not treat residents with dignity and respect, staff member smokes marijuana on the premises in the presence of residents, staff did not administer medication as prescribed, staff did not provide a comfortable environment for residents in care, and uncleared staff on the premises. Therefore, the allegations are deemed UNSUBSTANTIATED at this time.

SUPERVISOR'S NAME: Karen Clemons	TELEPHONE: (951) 248-0349
LICENSING EVALUATOR NAME: Javier Prieto	TELEPHONE: 951-217-3135
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

LIC9099 (FAS) - (06/04)

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