370804788-1-28-2023-08-AS-DPOL-CNLVJC-20230131152831

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804788
Report Date: 01/28/2023
Date Signed: 01/28/2023 01:46:17 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/24/2021 and conducted by Evaluator Liliana Silveira

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20211224104219

FACILITY NAME:	CASA EL CAJON		FACILITY NUMBER:	370804788
ADMINISTRATOR:	REBECCA RAYO		FACILITY TYPE:	740
ADDRESS:	306 SHADY LANE		TELEPHONE:	(619) 440-1335
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY:	99	CENSUS: 96	DATE:	01/28/2023
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Caregiver Ma. Resalyn Ocenar		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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-Facility did not allow unvaccinated visitors.
-Resident missed a medical appointment while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Liliana Silveira conducted a complaint investigation visit to deliver findings for the above-mentioned allegation. LPA Silveira met with Caregiver Ma. Resalyn Ocenar and shared the findings.

The Department’s investigation consisted of interviews and observations. On 12/24/21, it was alleged that the facility did not allow unvaccinated visitors. On 01/03/22 during an initial visit, LPA observed that the facility was following COVID-19 protocols required by Community Care Licensing Division (CCLD). All visitors were required to show proof of vaccination or a COVID-19 negative test upon entrance. An interview with the Administrator and outside sources revealed that unvaccinated visitors who arrived to the facility were asked to remain in the front area until residents were able to come to them. Interviews with residents and outside sources also revealed that there were no concerns reported about visitors not having access to residents. (CONTINUED ON LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2023

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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Control Number 08-AS-20211224104219

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: CASA EL CAJON	FACILITY NUMBER: 370804788
	VISIT DATE: 01/28/2023

NARRATIVE

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(continued from LIC 9099) It was also alleged that a resident missed a medical appointment while in care. No information was provided regarding the identity of the resident or date when the medical appointment was missed. Interviews with residents and outside sources revealed that there have been no issues with residents getting assistance for medical care. Interviews with the Administrator and outside sources also revealed that a facility bus provided transportation to appointments and general doctors conducted in house visits weekly. Residents also received assistance from the facility or from special programs to coordinate transportation to medical appointments. There was not enough evidence to support this allegation.

Due to lack of corroborating evidence, the findings regarding the above allegation were established to be unsubstantiated. This finding means that although the allegation may have happened or could be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

LPA Silveira conducted an exit interview with Ma. Resalyn. At the time of the exit interview Ma. Resalyn was provided with a copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 01-2016) and signature on this report acknowledges receipt of the rights.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2023

LIC9099 (FAS) - (06/04)

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