366405765-5-23-2024-56-AS-EMAN-DA6MXH-20241018095959

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366405765
Report Date: 05/23/2024
Date Signed: 05/23/2024 01:33:27 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 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
01/30/2024 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240130085540

FACILITY NAME:	CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA		FACILITY NUMBER:	366405765
ADMINISTRATOR:	RODNEY PEEK		FACILITY TYPE:	735
ADDRESS:	22200 HIGHWAY 18		TELEPHONE:	(760) 247-7711
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92307
CAPACITY:	54	CENSUS: 35	DATE:	05/23/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Stephanie Kaplan and Maria Pinto		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff engaged in a verbal altercation with resident.
Unqualified staff administered medications to residents.
Staff does not treat resident with dignity or respect.
Staff mishandling residents medication.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to deliver findings on the allegations listed above. LPA met with Administrator Stephanie Kaplan and Residential Manager Maria Pinto and explained the purpose of the visit. The investigation consisted of staff interviews, client interviews and record review.

For the allegation, Staff engaged in a verbal altercation with resident.

LPA Rico conducted seven (7) staff interviews. 7 out of the 7 staff stated they have not engaged in verbal altercation with residents. 5 out of the 7 staff stated they have not witness other staff engaged in verbal altercation residents.

LPA Rico conducted five (5) client interviews. 5 out of the 5 clients stated they have not been in a verbal altercation with a staff member.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024

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 56-AS-20240130085540

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: CASA COLINA CENTERS FOR REHABILITATION/PADUA VILLA	FACILITY NUMBER: 366405765
	VISIT DATE: 05/23/2024

NARRATIVE

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For the allegation, Unqualified staff administered medications to residents.

During staff interviews, 7 out of the 7 staff informed LPA only med-techs are allowed to pass medications. 4 out the 7 staff informed LPA Rico they are trained to pass medications. 3 out of the 7 staff stated they have not witnessed a staff pass medication without being trained. In addition, during record review, LPA verified staff members have received medication training.

For the allegation, Staff does not treat resident with dignity or respect.

During staff interviews, 7 out of the 7 staff informed LPA they treat their clients with dignity and respect.

During clients’ interviews, 5 out of the 5 clients stated the facility staff treat them with respect and dignity.

For the allegation, Staff mishandling residents’ medication.

During staff interviews, 5 out of 7 staff stated they have not mishandled residents’ medications. 2 out of the 7 staff stated they do not pass medication.

During clients’ interviews. 5 out of the 5 clients informed LPA they would not know if a staff members are mishandling their medications. 5 out of 5 clients also stated they receive all of their medications.

During medication audit. LPA observed client’s medications. All medications were dispensed properly and documented .

Based on the evidence found during the investigation, the four (4) allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

An exit interview was conducted, and this report (LIC9099) was discussed and provided Residential Manager Maria Pinto, along with a copy of the appeal right.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024

LIC9099 (FAS) - (06/04)

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