366425828-5-10-2023-56-AS-EMAN-CS4RXD-20230523132433

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366425828
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:58:30 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
03/06/2023 and conducted by Evaluator Victoria Chitgian

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20230306110239

FACILITY NAME:	VISTA CARE CENTER		FACILITY NUMBER:	366425828
ADMINISTRATOR:	ANITA N. LAYGO		FACILITY TYPE:	735
ADDRESS:	25155 VIS VISTA RD		TELEPHONE:	(760) 813-3022
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92307
CAPACITY:	5	CENSUS: 4	DATE:	05/10/2023
		UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Lead Staff - Paulino Esquillo		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Resident was not picked up from the hospital in a timely manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Victoria Chitgian conducted an unannounced visit to the facility to deliver the findings for the above complaint allegation. LPA met with lead staff Paulino Esquillo and explained the purpose of the visit.

The allegation states Resident was not picked up from the hospital in a timely manner. The investigation consisted of interviews and record review. Interviews with Staff indicate that clients are picked up from the hospital when called for discharge. Staff also state the family members will arrange car service when called by the hospital. Records review show client was brought home by an Uber ride within 3 hours of discharge.

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, therefore the allegation is UNSUBSTANTIATED at this time.
An exit interview was conducted where this report was discussed and provided to lead staff Paulino Esquillo.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Victoria Chitgian
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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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