<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370804823
Report Date: 12/19/2024
Date Signed: 12/19/2024 01:04:36 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
05/26/2021 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20210526114412
FACILITY NAME:ST. PAUL'S VILLAFACILITY NUMBER:
370804823
ADMINISTRATOR:ELEANOR DOWNINGFACILITY TYPE:
740
ADDRESS:2340 FOURTH AVENUETELEPHONE:
(619) 232-2996
CITY:SAN DIEGOSTATE: CAZIP CODE:
92101
CAPACITY:200CENSUS: 107DATE:
12/19/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:LaTressa Downing - Executive DirectorTIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unlawful eviction.
Licensee did not report changes in resident’s condition to physician.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Amy Rodgers and Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above-mentioned allegation. LPAs identified themselves, explained the purpose of the visit and nature of the complaint to LatTressa Downing, Executive Director.

On 5/26/2021, the Department received this complaint which alleged, the facility illegally evicted Resident #1 (R1) [LIC 811 Confidential Names List was provided to identify the client.] and did not ensure changes in R1’s condition were reported to R1’s physician. The Department’s investigation included, facility tour, record reviews and interview with an outside source.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Angelica BoylesTELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20210526114412
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ST. PAUL'S VILLA
FACILITY NUMBER: 370804823
VISIT DATE: 12/19/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(Continued from LIC9099)

Regarding allegation of facility illegally evicting R1, records revealed R1 had a history of aggressive behavior, which R1’s physician was aware of. On 5/17/21 due to aggressive behaviors R1’s physician recommended R1 go to a hospital for psychological evaluation and medication review. As evidenced by records, while R1 was at UCSD Hospital, social worker recommended to facility that R1 be placed in a locked facility. Evidence further the indicated facilities Resident Service Coordinator evaluated R1 at UCSD Hospital and conducted a Resident Appraisal noting a higher level of care, which R1’s responsible party signed. R1 did not return to the facility from UCSD Hospital.

Regarding the allegation of not ensuring changes in R1’s condition were reported to R1’s physician, records obtained confirmed through emails, clinical notes, and physician communication that leading up to R1’s hospitalization R1’s physician was aware of changes. Further evidence reveals facility staff attempted to schedule a care conference with R1’s responsible party and R1’s physician prior to hospitalization.

The Department has investigated the allegations that the facility illegally evicted a resident and staff did not ensure changes in resident’s conditions were reported to a physician. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated.

An exit interview was conducted with LaTressa Downing, Executive Director, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.

SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Angelica BoylesTELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2