374600675-8-27-2024-08-AS-JLOT-D8N6LQ-20240830205443

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600675
Report Date: 08/27/2024
Date Signed: 08/27/2024 10:12:37 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
04/16/2024 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20240416094242

FACILITY NAME:	VI AT LA JOLLA VILLAGE		FACILITY NUMBER:	374600675
ADMINISTRATOR:	BOUDREAU, STEPHANIE		FACILITY TYPE:	741
ADDRESS:	8515 COSTA VERDE BLVD		TELEPHONE:	(858) 646-7700
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92122
CAPACITY:	783	CENSUS: 510	DATE:	08/27/2024
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Executive Director, Stephanie Boudreau		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff did not maintain a comfortable temperature for resident
Staff did not meet resident's dietary needs
Staff charged resident for services not rendered

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to deliver investigative findings. LPA was greeted by Executive Director, Stephanie Boudreau to whom she identified herself and discussed the purpose of the visit.

The Department investigated the above-listed complaint allegations. The investigation consisted of a tour of the facility, multiple interviews, and a detailed review of relevant records, including medical records and other relevant evidence pertinent to this investigation.

On April 16, 2024, Community Care Licensing (CCL) received a complaint alleging that facility staff did not maintain a comfortable temperature for resident (R1), [a LIC 811 Confidential Names List was provided to staff to identify the resident]. It was specifically alleged that the temperature in R1’s apartment was freezing (62-65 °F) because there was airflow coming through the front door from the hallway and that the facility’s heating, ventilation, and air conditioning systems (HVAC) blew cold air inside their apartment. (continue at LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

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-20240416094242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VI AT LA JOLLA VILLAGE	FACILITY NUMBER: 374600675
	VISIT DATE: 08/27/2024

NARRATIVE

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(Continue from LIC9099)

On April 18, 2024, a tour of the facility was conducted, and the apartment was observed to be clean and free from odors. There were two thermostats on the walls, one located inside R1’s bedroom. This thermostat was originally located in the hallway (middle section of the apartment). At the request of R1, facility staff relocated the thermostat inside R1's bedroom. The thermostat indicated the room temperature was 76 °F (degrees Fahrenheit), the temperature was set at 76°F. (The average room temperature in most homes falls between 68–76°F). Per Title 22 regulations the temperature should be within 68-85 °F. LPA noticed that R1 had multiple room thermometers inside their room on top of the dressers, and nightstands, all the room thermometers indicated the temperature to be between 74-76 °F. The 2nd wall thermostat was located in the living room and was observed with a room temperature reading of 78°F, the temperature was set at 77°F. In addition to the wall thermostat, LPA observed multiple room thermometers located on top of furniture in various places in the living room and dining room, the temperature readings ranged between 74-76°F. Note: LPA also observed that R1 had a room thermometer on their hands with a room temperature reading of 76°F. [Note: Every apartment in the facility was equipped with its HVAC unit and the thermostats are located inside each apartment unit. The residents have complete control of setting the thermostat temperature to meet their needs.]

LPA observed there was blue painter's tape around the entry door. R1 stated that they felt a draft coming through the door from the hallway and that was the reason they had placed the tape around the perimeter of the door to block the air from blowing into the apartment from the hallway. R1 asked the LPA to feel the draft, but the LPA was not able to feel any draft coming through the door when the door was closed. However, a draft could be felt coming through the door from the hallway as you open the door and when the door was wide open. The temperature in the hallway was comfortable for the LPA. LPA did not feel any air blowing outside in the hallway. R1 stated that at nighttime, is when they felt a draft as if a plane was flying inside the apartment. LPA conducted a brief interview with the housekeeper who was present during the visit and indicated they had no concerns with the temperature inside R1’s apartment. Interviews with facility management and the director of engineering indicated that the facility had been working with R1 in addressing their concerns since they reported the problem on November 13, 2023. Facility maintenance replaced the thermostats twice in November and December 2023 because R1 stated they were old and were not accurate. (Continue at LIC9099C)

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 08-AS-20240416094242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VI AT LA JOLLA VILLAGE	FACILITY NUMBER: 374600675
	VISIT DATE: 08/27/2024

NARRATIVE

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(Continue from LIC9099C)

In addition, R1 requested the thermostats to be relocated twice as well in December 2023 and in January 2024. Maintenance checked and replaced the vents inside their apartment and adjusted the vent louvres located in the hallway to point away from their entry door. Maintenance staff replaced the weather stripping of the entry door and tested it to ensure no air was coming through the door by placing a big blower directly outside the door. On April 8, 2024, R1 hired an independent HVAC consultant to conduct a study and investigate the heating and airflow issues in their apartment. Per an interview with the independent consultant, the project consisted of doing an initial document review, site inspection, preliminary analysis, and consultation with R1. The consultant said that they placed sensors inside the apartment, outside on the terrace, and in the hallway and the readings of the sensors did not detect or disclose any problems with the room temperature. The sensors were placed for several days continuously which monitored the temperature during the day as well as at night. The independent consultant’s findings were consistent with the studies conducted by the facility’s engineers and the maintenance staff. Interviews with multiple residents living on the same floor near R1’s apartment did not disclose any problems with their HVAC. Based on observations, interviews, and records reviewed, there was insufficient evidence that facility staff did not maintain a comfortable temperature in R1’s apartment.

It was also alleged that staff did not meet residents’ dietary needs. This allegation was previously investigated by CCL on August 8, 2022. A review of R1's residential agreement indicated that the provider would accommodate customary and reasonable special diets that are prescribed by a physician. A review of R1's Physician's Report dated April 23, 2024, indicated that R1 is allergic to dairy, eggs, and whey. A review of R1's medical records did not disclose any other changes in R1’s diet that required modifications ordered by R1’s physician. There were no records showing that the doctor prescribed any modifications based on medical necessity. Interviews were conducted with residents, including the Chair of the Residents’ Counsel. Residents interviewed indicated that modified diets were available for residents who needed them, including alternative meals for residents with allergies. Resident interviews also indicated that given the diverse population of the residents in care, the facility made every effort to please residents, however, some residents will enjoy certain items, whereas others will not.

(Continue at LIC9099C)

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 08-AS-20240416094242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VI AT LA JOLLA VILLAGE	FACILITY NUMBER: 374600675
	VISIT DATE: 08/27/2024

NARRATIVE

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(Continue from LIC9099C)

A detailed review of restaurant menus for April 2024 and observations of the lunch service at the facility during the visit conducted on April 18, 2024, indicated that the residents had a choice of four (4) appetizers to choose from, including two (2) soups and two (2) salads. The main entrée had nine (9) different choices to choose from, including a variety of proteins, including chicken, salmon, lobster, ham, crabs, and hamburgers. Based on interviews, observations, and records reviewed, there was insufficient evidence that the facility failed to adhere to the resident's dietary needs.

It was also alleged that staff charged R1 for services not rendered. It was specifically alleged that R1 was charged over $30,000 for food service and they do not eat any meals provided by the facility. R1 stated that they have food allergies and prefer to cook their meals. R1 stated they calculated the amount overcharged by taking the average cost of a meal $25 and multiplying it by the days they have not eaten at the facility. A review of the residency agreement signed by R1 indicated that on October 25, 2016, a memorandum was sent to all residents informing them of the meal plan changes. Effective November 1, 2016, all Independent Living residents will be moved to the “one meal a day” plan. Every month, each Independent Living unit will receive a resident meal allowance equivalent to the number of days in that month (i.e., November = 30 meal allowance; December = 31 meal allowance). The meal allowance will be doubled for those units occupied by two residents. At the time of the meal, you may decide if that meal will be deducted from your meal allowance or charged to your account. It was also indicated that if you did not fully utilize your monthly meal allowance, a credit of $5.50 per unused meal would be applied to the resident’s account at the end of that month and would appear on the following month’s statement. A review of R1's billing statements from (January 2023 - March 2024) showed that R1 received the correct meal credits for each month. R1 stated they do not eat the food provided by the facility because they prefer eating organic food. R1 resides in independent living and can make choices regarding what meals to eat and not eat. R1's medical records and facility assessments confirmed that R1 was independent and was able to make personal choices of which meals to eat to meet their dietary restrictions as well as opt not to eat at the facility and receive the agreed upon meal credit. Based on records reviewed and interviews conducted there was insufficient evidence that facility staff charged R1 for services not rendered.

(Continue from LIC9099C)

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 08-AS-20240416094242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VI AT LA JOLLA VILLAGE	FACILITY NUMBER: 374600675
	VISIT DATE: 08/27/2024

NARRATIVE

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(Continue from LIC9099C)

Based on the results of the investigation, which consisted of observations, interviews with key staff and outside sources, and review of pertinent resident and facility records there was insufficient evidence to support the allegations listed in this report. Therefore, these allegations are unsubstantiated. A finding that is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence that the alleged violation occurred.

An exit interview was conducted with Executive Director, Stephanie Boudreau, to whom a copy of this report, Confidential Names List (LIC 811), and Licensee Appeal Rights (9058 03/22) were provided at the conclusion of the visit.

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC9099 (FAS) - (06/04)

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