374600289-9-1-2022-08-AS-DPOL-CJRRBA-20220930125222

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600289
Report Date: 09/01/2022
Date Signed: 09/01/2022 10:59:47 AM

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
12/11/2020 and conducted by Evaluator Carmen Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20201211142913

FACILITY NAME:	LEMON GROVE TERRACE		FACILITY NUMBER:	374600289
ADMINISTRATOR:	CELIA A. MENESES		FACILITY TYPE:	740
ADDRESS:	8554 CALLE NORTE		TELEPHONE:	(619) 463-6705
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	6	CENSUS: 4	DATE:	09/01/2022
		UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Celia A. Meneses, Licensee		TIME COMPLETED:	11:10 AM

ALLEGATION(S):

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- Licensee is not treating residents with dignity.
- Licensee did not distribute medication as prescribed.
- Licensee is restricting resident access to facility premises.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Celia Meneses, Licensee. LPA stated the purpose of the visit and reviewed the findings of the complaint with Licensee Meneses.

The Department’s investigation consisted of interviews with staff and outside source, records review of relevant documents pertinent to this investigation, and LPA observation of the facility grounds. On December 11, 2020, it was alleged that the Licensee did not treat residents with dignity.

Interview with an outside source-maintained staff #1 (S1) had thrown away resident #1’s (R1) food which R1 received from a relative who dropped off a burrito. Per the outside source, when R1 requested to eat the burrito for breakfast, S1 said “no” and tossed the burrito into the trash. Interview with staff confirmed R1’s relatives would drop off food for R1 at the facility but denied throwing R1’s food away.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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-20201211142913

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: LEMON GROVE TERRACE	FACILITY NUMBER: 374600289
	VISIT DATE: 09/01/2022

NARRATIVE

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Staff said R1’s food would be stored if the food was non-perishable and did not need refrigeration. Per staff, R1’s food would be placed in a drawer in R1’s room and was not tossed into the trash. Per staff, R1 had a drawer specifically for snacks.

On December 11, 2020, it was also alleged that the Licensee did not distribute medications as prescribed. Interview with an outside source revealed R1 was given resident #2’s (R2) medication. Outside source was not able to give detailed information. Interview with staff revealed R1 at times refused medication but was not given incorrect medication. During the subsequent visit, LPA observed there was no medication administration record (MAR) for R1 in the file. There was no record found in any file to document if R1 or other residents had taken medication(s).

Interview with an outside source maintained R1 yelled at staff for throwing away their burrito and since that incident, R1 was restricted to their room and not allowed to eat with the other residents. Interview with staff revealed R1 would have arguments with staff and other residents but was not restricted to their room. According to staff, R1 had access to the entire facility. S1 mentioned residents would opt to eat in their rooms if requested. Per staff, R1 did choose to eat in their room at times due to being cold. On 12/18/2020, LPA virtually toured the facility. While on tour, LPA inquired about the residents eating habits. Per staff, some residents would eat in the dining area and some residents would eat in their rooms. R1 would, at the time, choose to eat in their room due to being cold. During the subsequent visit on 8/19/2022, LPA observed three residents ate in the same dining area together. No resident stated they had any restrictions on where to eat.

Based on the Department’s investigation of the above-mentioned allegations and the evidence obtained during staff and outside source interviews and records reviewed, there is not sufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegations are deemed to be unsubstantiated.

An exit interview was conducted with Licensee Celia A. Meneses. A copy of this report along with Licensee/Appeal Rights (LIC9058 01/16) was provided to Licensee Menses at the conclusion of the visit. The signature below confirms receipt of the documents.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC9099 (FAS) - (06/04)

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