370804788-4-29-2023-08-AS-DPOL-CRE6FP-20230430204640

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804788
Report Date: 04/28/2023
Date Signed: 04/29/2023 02:05:59 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
03/22/2023 and conducted by Evaluator Liliana Silveira

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230322154130

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: 90	DATE:	04/28/2023
		UNANNOUNCED	TIME BEGAN:	04:35 PM
MET WITH:	Administrator Rebecca Rayo		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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-Resident was not treated with dignity and respect.
-Staff denied resident visit because of visitor's vaccination status.
-Facility did not report unusual incidents involving residents as required.

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 Administrator Rebecca Rayo and shared the findings.

The Department’s investigation consisted of observations, interviews, and records review. On 03/22/23 it was alleged that Resident #1 (R1) was not treated with dignity and respect, mainly, that the resident was forced to cut their hair and was not addressed by their nickname. Interviews with staff, residents and outside sources revealed that the facility provides a free, voluntary haircutting service. Interviews with residents revealed that residents themselves request the haircutting services when needed. Residents expressed that they have never been forced to get a haircut and have never seen anyone being forced to get a haircut and expressed appreciation for the free haircut services. Interviews with staff and outside sources also revealed that R1 had requested the haircutting service. Interviews with staff and outside sources also revealed that R1 was referred to throughout the interviews using R1s nickname. (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: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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-20230322154130

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: 04/28/2023

NARRATIVE

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It was also alleged that staff denied a resident a visit because of visitor’s vaccination status, specifically during the month of May 2021. A records review, as well as interviews with outside sources, staff and residents revealed that during May 2021 the facility was following CCLD COVID-19 Mitigation protocols, as required by CCLD and the State of California Department of Social Services. These protocols required that visitors be vaccinated to be allowed entrance into the facility. Interviews with outside sources and staff also revealed that R1 and other residents were able to see unvaccinated visitors at the entrance of the building or outside in the front of the building.

It was also alleged that the facility did not report unusual incidents involving R1 from 2022 to January 2023. A records review revealed that unusual incident reports were sent by facility staff to CCLD for the incidents that occurred during that time frame.

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

LPA Silveira conducted an exit interview with Rebecca. At the time of the exit interview Rebecca 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: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC9099 (FAS) - (06/04)

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