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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 372008105
Report Date: 12/15/2023
Date Signed: 12/15/2023 12:56:15 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/18/2020 and conducted by Evaluator Dawn Segura
COMPLAINT CONTROL NUMBER: 08-AS-20200918143906
FACILITY NAME:LEARNING SERVICES ESCONDIDO-ADULT RESIDENTIALFACILITY NUMBER:
372008105
ADMINISTRATOR:HENRY, LORIFACILITY TYPE:
735
ADDRESS:2335 BEAR VALLEY PARKWAYTELEPHONE:
(760) 746-3223
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:28CENSUS: 18DATE:
12/15/2023
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Kathi Baer, AdministratorTIME COMPLETED:
01:05 PM
ALLEGATION(S):
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Facility did not report incident to Community Care Licensing.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigative finding. LPA was granted entry into the facility and met with Kathi Baer, to whom she disclosed the reason for the visit.

Community Care Licensing (CCL) has investigated the above-listed complaint allegation. The investigation consisted of review of records and interviews of facility staff.

It was reported that Client 1 (C1) [LIC 811 Confidential Names List was provided to identify the client] had a fall while away from the facility. As a result of the fall, C1 sustained a laceration to the hand, which resulted in C1 being transported to receive medical evaluation. It was alleged that the incident was not reported to CCL. Evidence gathered during the investigation confirmed that C1 was transported to a hospital emergency room on 9/15/2020. Evidence further indicated that C1 was seen in the emergency room, where the hand
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
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 5
Control Number 08-AS-20200918143906
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: LEARNING SERVICES ESCONDIDO-ADULT RESIDENTIAL
FACILITY NUMBER: 372008105
VISIT DATE: 12/15/2023
NARRATIVE
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that sustained a laceration was bandaged by hospital personnel. Subsequently, on a later date, C1 returned for additional medical attention for the same laceration, at which time, it was discovered that glass remained in C1’s hand from the initial incident. During the visit, C1’s hand wound was reopened to allow for removal of the glass. A search of incident reports received by CCL did not yield any special incident report notifying of the incident or transport of C1 to any facility for medical services in response to this incident.

Accordingly, the allegation is substantiated. This finding means that the preponderance of evidence standard has been met and the allegation is valid. Deficiency is cited in accordance with California Code of Regulations, Title 22, Division 6, Chapter 8 and noted on the attached LIC 9099-D.

An exit interview was conducted with Kathi Baer, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided to the administrator at the conclusion of the visit. Kathi Baer’s signature on this report acknowledges receipt of copies of the rights and report.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/18/2020 and conducted by Evaluator Dawn Segura
COMPLAINT CONTROL NUMBER: 08-AS-20200918143906

FACILITY NAME:LEARNING SERVICES ESCONDIDO-ADULT RESIDENTIALFACILITY NUMBER:
372008105
ADMINISTRATOR:HENRY, LORIFACILITY TYPE:
735
ADDRESS:2335 BEAR VALLEY PARKWAYTELEPHONE:
(760) 746-3223
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:28CENSUS: DATE:
12/15/2023
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:TIME COMPLETED:
01:05 PM
ALLEGATION(S):
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Facility staff did not seek timely medical attention for client.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigative findings. LPA was granted entry into the facility and met with Kathi Baer, Administrator, to whom she disclosed the reason for the visit.

Community Care Licensing (CCL) has investigated the above-listed complaint allegation. The investigation consisted of reviews of facility and outside source records and interviews of facility staff.

It was reported to Community Care Licensing that Client 1 (C1) sustained a laceration to the hand, and facility staff did not seek medical attention until it was too late for medical action to be taken to address the laceration.

Based upon information reviewed during the investigation, C1, who is a client who is relatively independent in care, spends time away from the facility each weekend, leaving on Friday and returning at 10:00 PM on
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 08-AS-20200918143906
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: LEARNING SERVICES ESCONDIDO-ADULT RESIDENTIAL
FACILITY NUMBER: 372008105
VISIT DATE: 12/15/2023
NARRATIVE
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Monday night. It was discovered during the investigation that on a Monday evening, while C1 was away from the facility, C1 experienced a fall that resulted in a hand laceration. It is unclear as to the exact time that the injury occurred, but interviews indicate that the incident and resulting injury occurred at least a couple of hours prior to C1’s return. As was C1’s routine, C1 returned to the facility at approximately 10:00/10:30 PM, and staff were made aware of the laceration. Evidence indicates that the facility’s nurse, who was not onsite, was sent a photo of C1’s hand at approximately 11:45 PM, and C1’s hand was evaluated by the nurse on the following day. C1 was informed by the facility’s nurse that medical attention was required. Interviews yielded that C1 was transported by facility staff to an urgent care location and, subsequently, a local emergency room. According to evidence obtained during the investigation, no medical services were provided at the urgent care location. While in the emergency room, C1’s hand was bandaged, and C1 was sent back to the facility. C1 and accompanying staff were informed that no additional medical action could be taken at that time because too much time had lapsed since the laceration occurred. C1 and staff were informed that medical attention should have been sought at the time the incident and resulting injury occurred.

As indicated above, the incident that caused the laceration occurred while C1 was away from the facility and not under the direct care of facility staff, C1 was advised by hospital personnel that the laceration should have been treated at the time it occurred, and facility staff were not aware of the injury until hours after the occurrence. The foregoing does not yield evidence that is sufficient enough to conclude that hospital staff’s inability to take additional medical action at the time C1 was evaluated was due to lack of action by facility staff.

Based upon the foregoing, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted with Kathi Baer, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided to the administrator at the conclusion of the visit. Kathi Baer’s signature on this report acknowledges receipt of copies of the rights and report.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20200918143906
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: LEARNING SERVICES ESCONDIDO-ADULT RESIDENTIAL
FACILITY NUMBER: 372008105
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/05/2024
Section Cited
CCR
80061
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(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency...a written report. . .shall be submitted to the licensing agency within seven days following the occurrence of such event. (1)(D) Any injury to any client which
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A new administrator has been put in place since the time of the incident. Administrator informed LPA that since she has taken over the role of administrator, incident reports have been submitted to Community Care Licensing on behalf of the facility any time
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requires medical treatment. This req't was not met as evidenced by: Based upon record review and interview, the licensee did not submit a written report of the injury to Community Care Licensing within seven days following the incident for 1 of 14 clients in care which posed a potential health risk to persons in care.

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any client is taken for medical attention in response to an unusual incident. Administrator agreed to provide a copy of the facility's updated internal policy regarding reporting requirements to CCL by the POC due date of 1/5/2024.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5