374600872-4-20-2023-08-AS-LTEZ-CRBVFV-20230428162431

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600872
Report Date: 03/29/2023
Date Signed: 04/20/2023 12:35:23 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, 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
05/19/2022 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20220519122346

FACILITY NAME:	OCEAN VIEW HOMES III		FACILITY NUMBER:	374600872
ADMINISTRATOR:	ALICIA MILLAN		FACILITY TYPE:	740
ADDRESS:	6602 AVENIDA MIROLA		TELEPHONE:	(858) 551-2736
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY:	6	CENSUS: 5	DATE:	03/29/2023
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Administrator, Alicia Millan		TIME COMPLETED:	05:50 PM

ALLEGATION(S):

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Staff did not maintain facility clean
Staff did not maintain kitchen equipment clean

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation visit to conduct additional interviews and deliver findings. The LPA introduced himself and disclosed the purpose of the visit to Administrator, Alicia Millan.

Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources.

It was alleged Staff did not maintain the facility clean. Multiple sources reported to the Department the facility yard was in disrepair, and the interior was not kept clean. Interviews with internal and external sources revealed the facility maintenance personnel had stopped maintaining the yard. This led to an over grow of weeds and bushes in the yard. No concerns were reported regarding the interior of the facility not being cleaned.
(See LIC 9099C for continuation of report.)

Substantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel Martinez	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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-20220519122346

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: OCEAN VIEW HOMES III	FACILITY NUMBER: 374600872
	VISIT DATE: 03/29/2023

NARRATIVE

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Observations by the LPA did not corroborate the interior to be unclean. The LPA’s observations did corroborate the yard was not kept clean, as walkways in the yard were witnessed to be covered by overgrown plants and bushes.

It was alleged the staff did not keep equipment clean. It was reported to the Department the facility refrigerator, freezer and oven were witnessed to be dirty, on multiple occasions. Observations by the LPA, on multiple visits to the facility, corroborated the refrigerator, freezer and oven were not kept clean. Interviews with internal sources revealed conflicting statements of when the equipment was last cleaned.

Based on evidence obtained throughout the investigation, the allegations were Substantiated. The deficiencies were cited in accordance with California Code of Regulations, Title 22, and listed on the LIC 9099D. A plan of correction was jointly formulated with Administrator, Alicia Millan.

An exit interview was conducted with Administrator, Alicia Millan, to whom a copy of this report, LIC 9099D and Licensee/Appeals Rights (LIC 9058) were provided.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel Martinez	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220519122346

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: OCEAN VIEW HOMES III	FACILITY NUMBER: 374600872
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/29/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/29/2023 Section Cited CCR 87303(a)	1 2 3 4 5 6 7	87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Administrator agreed to provide the LPA photographic evidence of maintained/ cleaned yards, by 4/28/2023.
	8 9 10 11 12 13 14	Based on observations and interviews, the licensee did not ensure the facility yards were not in good repair wich posed a potential health, safety and personal rights risk to 5 of 5 residents in care.	8 9 10 11 12 13 14
Type B 03/29/2023 Section Cited CCR 87555(b)(29)	1 2 3 4 5 6 7	87555 General Food Service Requirements (b) The following food service requirements shall apply: (29) All equipment, fixed or mobile, and dishes, shall be kept clean and maintained in good repair and free of breaks, open seams, cracks or chips. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Administrator agreed to implement a cleaning schedule and submit proof of cleaning schedule to the LPA, by 4/28/2023.
	8 9 10 11 12 13 14	Based on observations and interviews, the licensee did not ensure kitchen equipment was maintained clean, which posed a potential health, safety, and personal right risk to 5 of 5 residents in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 767-2317
LICENSING EVALUATOR NAME: Sabel Martinez	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC9099 (FAS) - (06/04)

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