374600661-5-12-2023-08-AS-SJAB-CSCRYM-20230531132634

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600661
Report Date: 05/12/2023
Date Signed: 05/12/2023 05:10:49 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
05/09/2023 and conducted by Evaluator Daniel Pena

COMPLAINT CONTROL NUMBER: 08-AS-20230509161051

FACILITY NAME:	CALIFORNIA HOME FOR SENIORS		FACILITY NUMBER:	374600661
ADMINISTRATOR:	GLORIA S. QUILLOPE		FACILITY TYPE:	740
ADDRESS:	1061 E. BRADLEY AVENUE		TELEPHONE:	(619) 448-2870
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY:	15	CENSUS: 12	DATE:	05/12/2023
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Gloria S. Quillope, Administrator		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Financial Abuse

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced visit to commence a complaint investigation. LPA introduced himself, was granted entry into the facility, and met with Juliette Ortega, Caregiver, to whom LPA disclosed the reason for the visit. During the visit, LPA toured the facility, reviewed records, and interviewed residents and pertinent staff. Licensee, Gloria Quillope later arrived and LPA discussed with her the findings of the investigation.

It was alleged that the facility financially abused Resident 1 (R1).

R1 was admitted to California Homes for Seniors on April 20, 2023. On May 4, 2023, Staff 1 (S1) notified an outside source that the facility had not received R1’s payment. Interviews revealed that these payments were sent electronically using a digital payment network application. S1 did not provide the outside source with evidence that R1’s payment had not been received. The outside source later verified with R1’s financial institution and confirmed that the payments were posted to the facility. The source communicated this to S1. Interviews also revealed that S1 allegedly attempted to extract

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: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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 08-AS-20230509161051

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: CALIFORNIA HOME FOR SENIORS	FACILITY NUMBER: 374600661
	VISIT DATE: 05/12/2023

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

additional funds from R1. Interviews reported that S1 told the outside source that R1’s application to a financial subsidy program had not yet been approved and R1 would be responsible for payment for all services. S1 told the source that once R1’s application was approved, a portion of the fees would be refunded to R1.

Investigation confirmed that, at around the time of R1’s intake, R1 applied for a financial subsidy program. As part of this investigation, LPA reviewed the elements of the subsidy program, which essentially provides specified benefits to eligible seniors and persons with disabilities. The program reimburses for services provided to residents enrolled in the program, however, the resident is responsible to pay for their own room and board.

Interviews with pertinent parties indicated that this matter has been resolved. Interviews confirmed R1's funds were posted and processed accordingly. It appears navigating the digital payment application and gaining clear understanding of the subsidy program contributed to confusion. Interviews confirmed that there is no concern of neglect or abuse towards R1 by the facility.

This investigation did not yield sufficient evidence to conclude that the licensee financially abused R1. 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 the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Ms. Quillope, and a copy of this report and Licensee/Appeal Rights (LIC 9058) were provided to Ms. Quillope at the conclusion of the visit.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2