370804823-10-10-2023-08-AS-SJAB-CX5NDG-20231031102220

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804823
Report Date: 10/10/2023
Date Signed: 10/10/2023 05:28:40 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
10/05/2023 and conducted by Evaluator Daniel Pena

COMPLAINT CONTROL NUMBER: 08-AS-20231005094127

FACILITY NAME:	ST. PAUL'S VILLA		FACILITY NUMBER:	370804823
ADMINISTRATOR:	ELEANOR DOWNING		FACILITY TYPE:	740
ADDRESS:	2340 FOURTH AVENUE		TELEPHONE:	(619) 232-2996
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92101
CAPACITY:	200	CENSUS: 111	DATE:	10/10/2023
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Eleanor Downing, Administrator		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Facility did not take necessary precautions to prevent a scabies outbreak

INVESTIGATION FINDINGS:

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On 10/10/2023, at about 2:30 PM, Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced visit to the facility in order to initiate a complaint investigation. LPA was granted entry to the facility by Eleanor Downing, Administrator, after identifying himself and explaining the reason for the visit.

On 10/5/2023, the Department received an allegation that the facility did not take necessary precautions to prevent an infectious disease outbreak. Allegedly, two residents were not treated for an infectious disease but the facility removed their clothing. Also, it was alleged that residents were placed into isolation but the families were not notified. Finally, it was alleged that two residents were isolated without clothing. The Department’s investigation consisted of LPA observations, review of facility records, and interviews with pertinet staff, residents and outside sources.

On 10/10/2023, LPA’s visit included a walk-through of the facility, specifically the Memory Care Unit (MCU). LPA interviewed one of the affected residents by telephone, the resident said they were fully dressed and had never been left without clothing. The resident understood why they were in isolation but said they did not have an infectious disease.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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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Control Number 08-AS-20231005094127

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ST. PAUL'S VILLA	FACILITY NUMBER: 370804823
	VISIT DATE: 10/10/2023

NARRATIVE

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(Continued from LIC9099)

Interviews and records revealed that in September 2023, two residents in MCU complained to staff of having rashes and itching. The facility arranged for the two residents to be evaluated by their primary care physician. The reports for both residents did not indicate a diagnosis of infectious disease but both were given medicated creams for the itching.

About a week later, a third MCU resident reported they had rash and itching. The resident was seen by their PCP and later a dermatologist. The facility was notified that the dermatologist diagnosed the resident with an infectious disease spread by skin to skin contact.

Records obtained by LPA, show that on 10/5/2023, the facility sent an email to the families of all residents assigned to the MCU. The message essentially informed families of confirmed infectious disease cases in the MCU. The facility indicated that they had consulted with medical professionals and the California Department of Public Health. The facility stated they treated all MCU residents and staff assigned to work in the MCU. The message also informed families that the facility would be delivering a second treatment in seven days. Additionally, the message noted that visitation was still permitted with the appropriate precautions taken, specifically proper contact and hand washing. The message also noted that PPE, to include, gloves, gowns, masks, shoe covers would be made available upon request.

Record reviews noted that the facility followed infectious control disease guidance from CDPH and their own skin-to-skin contact infectious control policies and procedures.

Interviews indicated that of the 51 MCU residents in isolation only 19 were diagnosed with the disease and showed symptoms. The remaining 32 residents were not diagnosed as positive and were asymptomatic. The remaining residents were still given treatment including isolation out of precaution.

Interviews revealed that three MCU staff complained of itching and rash but were not diagnosed with an infectious disease. However, out of precaution, the facility followed CDPH guidance and are having the affected staff isolate and receive treatment. Also, facility nursing staff provided face to face information to affected family members. A conversation with one family include an explanation why resident clothing was

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20231005094127

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ST. PAUL'S VILLA	FACILITY NUMBER: 370804823
	VISIT DATE: 10/10/2023

NARRATIVE

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(Continued from LIC9099-C)

bagged and sanitized. This conversation included explaining that all affected residents were allowed to select clothing to be worn during the 14-day isolation period.

The Department has investigated the allegation that the facility did not take necessary precautions to prevent an infectious disease outbreak. Based on records and interviews, there is no information to corroborate or support the allegation, therefore, the preponderance of evidence standard was not met. The allegation is UNSUBSTANTIATED.

An exit interview was conducted with Administrator Downing and a copy of this report and the Licensee's Rights (LIC9058) were provided to Administrator Downing.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC9099 (FAS) - (06/04)

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