374600619-1-26-2024-08-AS-JLOT-D22492-20240131175335

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600619
Report Date: 01/26/2024
Date Signed: 01/26/2024 05:04:15 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
01/11/2024 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20240111090828

FACILITY NAME:	LEICHTAG FAMILY ASSISTED LIVING RESIDENCE		FACILITY NUMBER:	374600619
ADMINISTRATOR:	CARL MEASER		FACILITY TYPE:	740
ADDRESS:	211 SAXONY ROAD		TELEPHONE:	(760) 632-0081
CITY:	ENCINITAS	STATE: CA	ZIP CODE:	92024
CAPACITY:	77	CENSUS: 41	DATE:	01/26/2024
		UNANNOUNCED	TIME BEGAN:	04:48 PM
MET WITH:	Nina Haaland, LVN Supervisor		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Licensee did not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced visit to deliver findings regarding the above complaint allegation. LPA introduced herself and disclosed the purpose of the visit to Nina Haaland, LVN Supervisor.

On 1/11/24 it was alleged that Licensee did not safeguard resident's (R1) personal belongings due to a sum of missing money. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, outside sources, and LPA direct observations. Staff interview revealed that upon admission, R1 waived their rights to an itemized inventory of their property. Staff interview further revealed that the Licensee was not made aware that the money existed in R1's possession until after the claim was made that it had been taken. Staff interview revealed that the Licensee provided every resident with a personal safe; R1 had an additional safe installed in their room, to which no staff member had access.

Continued on LIC9099-C p.2

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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-20240111090828

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: LEICHTAG FAMILY ASSISTED LIVING RESIDENCE	FACILITY NUMBER: 374600619
	VISIT DATE: 01/26/2024

NARRATIVE

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Continued from LIC9099 p.1

Resident interview did not corroborate the allegation, as R1 confirmed that the Licensee assisted them in taking steps to protect their belongings. Outside source interview revealed that the incident was investigated by the local police agency who determined that the Licensee took steps to protect R1's personal property; no evidence was found to support the allegation. Records review corroborated staff statements regarding R1's waiver to inventory personal property, which was signed on 10/30/23. Records review further revealed that once they were made aware of the missing money, the Licensee made the required notifications within the required timeframes to all agencies and responsible parties. During an unannounced facility visit LPA directly observed both the facility-installed safe and R1's personal safe in their apartment.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Nina Haaland, LVN Supervisor, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

LIC9099 (FAS) - (06/04)

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