371881361-6-20-2023-18-AS-MVAO-CV7SBE-20230830134348

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 371881361
Report Date: 06/20/2023
Date Signed: 06/20/2023 04:09:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
05/26/2023 and conducted by Evaluator Chinwe Nwogene

COMPLAINT CONTROL NUMBER: 18-AS-20230526170110

FACILITY NAME:	QUIET HILLS LIVING		FACILITY NUMBER:	371881361
ADMINISTRATOR:	BLAKE, MARY ANN		FACILITY TYPE:	740
ADDRESS:	884 GRETNA GREEN WAY		TELEPHONE:	(760) 270-2075
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92025
CAPACITY:	6	CENSUS: 6	DATE:	06/20/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Cherry Cook, Facility Operator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are sleeping in residents rooms.
Resident is drugged while in care.
Resident is not being showered while in care.
Facility is not serving nutritious meals to residents in care.
Facility did not ensure that residents are appropriately dressed.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 06/20/2023, Licensing Program Analysts (LPAs), Venus Mixson and Chinwe Nwogene conducted an unannounced visit to conclude the complaint investigation into the allegations listed above. LPAs met with facility operator, Cherry Cook who was informed of the purpose of the visit. During the investigation, staff, resident and witnesses were interviewed and facility record was reviewed.
Regarding the allegation “Staff are sleeping in residents’ rooms”, it was alleged staff sleep in resident rooms. LPA interviewed staff who denied sleeping in residents’ rooms. LPA interviewed residents who denied staff sleep in resident rooms.
Regarding the allegation “Resident is drugged while in care”, LPA interviewed staff who denied staff drugs residents. Staff stated staff follows doctors’ orders when administering resident medications. LPA interviewed residents who denied staff drugs residents.
Regarding the allegation “Resident is not being showered while in care”, LPA interviewed staff who stated some residents are showered once a week and some are showered twice a week. LPA interviewed Residents who denied not being showered.

Continue on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Chinwe Nwogene	TELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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 18-AS-20230526170110

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: QUIET HILLS LIVING	FACILITY NUMBER: 371881361
	VISIT DATE: 06/20/2023

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 the allegation “Facility is not serving nutritious meals to residents in care”, LPA interviewed staff who stated residents are fed three #3 times a day with snack in between meals. During LPA’s interview with residents, it was acknowledged residents are fed three #3 times a day with snacks in between meals. LPA reviewed food menu and found it to be adequate.

Regarding the allegation “Facility did not ensure that residents are appropriately dressed”, LPA interviewed staff who stated residents are always dressed. Staff stated staff assists residents with dressing. LPA interviewed residents who denied staff are not ensuring that residents are appropriately dressed. During LPA’s visit, LPA observed residents are appropriately dressed.

Witnesses were interviewed who denied all the allegations listed above.

Based on LPA’s interviews with staff, residents and witnesses and a review of facility records, there is not enough evidence to support the above allegations. Although the allegations 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 allegations are unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Cherry Cook.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Chinwe Nwogene	TELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2