374601046-12-17-2024-08-AS-SJAB-DC5QBD-20241220110123

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601046
Report Date: 12/17/2024
Date Signed: 12/17/2024 12:13:19 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/14/2022 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20220114123811

FACILITY NAME:	BROOKDALE PLACE OF SAN MARCOS		FACILITY NUMBER:	374601046
ADMINISTRATOR:	PRESTON, MARIO		FACILITY TYPE:	740
ADDRESS:	1590 W SAN MARCOS BLVD		TELEPHONE:	(760) 471-9904
CITY:	SAN MARCOS	STATE: CA	ZIP CODE:	92078
CAPACITY:	245	CENSUS: 167	DATE:	12/17/2024
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Amber Rodgers, Associate Executive Director		TIME COMPLETED:	12:22 PM

ALLEGATION(S):

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Resident was denied being taking to the ER
Facility is overcharging resident for food
Facility did not provide resident with a new call button bracelet
Staff did not check on resident in a timely manner
Visitors being denied entry into facility due to COVID

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to deliver investigative findings. LPA was granted entry into the facility and identified herself to Amber Rodgers, Associate Executive Director to whom LPA explained the reason for the visit.

On January 14, 2022 Community Care Licensing (CCL) received a complaint alleging that a resident (R1) was denied being taking to the ER. [LIC811 Confidential Name List was provided to staff to identify R1]. Interviews revealed on or around January 13, 2022, R1 stated that they were denied a ride to the emergency room (ER). Interviews revealed R1 did not recall the day or what the issue was. Interviews with staff revealed that there was never an issue reported to them regarding R1 needing a ride to the hospital. Interviews revealed that if R1 needed a ride out to the ER they would have taken them. Interviews revealed if a resident requests to go to ER they evaluate the resident to deem if it is a need for emergency services or medial transport which is for non emergencies.

It was alleged that the facility is overcharging resident for food. Interviews with staff with revealed that R1 is not on any meal plan and can go to the dining room to eat the meals. Interviews revealed that due to Covid all residents are getting meals. Interviews revealed R1 was recently sick in December and the staff would give R1 the menu for the day and would deliver their food. Interviews with R1 revealed they get their meals but they are coming when everybody else's is coming. Interviews revealed that R1 wants the food at the time they usually eat but since it is covid they are getting meals from the kitchen.

(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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-20220114123811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: BROOKDALE PLACE OF SAN MARCOS	FACILITY NUMBER: 374601046
	VISIT DATE: 12/17/2024

NARRATIVE

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(Continued from LIC 9099) R1 admitted they are not on a meal plan but has been getting food from the kitchen because the kitchen is feeding all residents due to covid. Interviews with R1 revealed they do not know how much a meal plan is because their father pays for everything. Interviews revealed they did not charge R1 for delivering the meals to the room while R1 was sick.

It was alleged that the facility did not provide resident with a new call button bracelet. Interviews with staff revealed if R1 was missing their pendant that they never brought it to the attention of management or staff. Interviews revealed there are extra pendants at the facility that they would have been able to give R1 if the pendant was missing. Interview with R1 revealed they did not mention to facility staff that their pendant was missing.

It was alleged that the staff did not check on resident in a timely manner. Interviews revealed that anytime a pendant is activated the staff will check on the resident. Interviews revealed there were no pendant calls from R1. Interviews revealed that any time R1 called down for assistance they would assist R1. Interviews revealed staff check on residents when they do their rounds. Interviews revealed the staff only know if something is wrong if the residents tell them when they come in to check on them. Interviews with R1 revealed that anytime there is an issue the staff come and check on them and then will report what type of help they need. R1 revealed they have not been denied any help or assistance that they can remember.

It was alleged that the visitors are being denied entry into facility due to COVID. Interviews revealed that the visitor policy is only updated when they get new guidance. The newest one that was dated 01/07/2022 at the time the complaint came in stated that from 01/07/22 - 02/07/2022 that indoor visits are permitted at the community if visitors show proof of vaccination of all recommended doses including the booster shot and for those eligible to receive the booster. They must also provide evidence of a negative Covid 19 test within 1 day of visit for rapid tests or within 2 days of visit for PCR tests.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220114123811

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: BROOKDALE PLACE OF SAN MARCOS	FACILITY NUMBER: 374601046
	VISIT DATE: 12/17/2024

NARRATIVE

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If visitors do not meet the vaccination requirements above, outdoor visits will be allowed. Interviews revealed that they have not denied anyone any visitation. Interview with R1 did not reveal that any of their visits were denied. Interview with R1 revealed that they have seen their friends. Interviews also revealed that R1 does not know of any visits being denied.

Based on the evidence obtained from interviews, records review, and outside sources, the complaint allegations of the resident was denied being taking to the ER, facility is overcharging resident for food, facility did not provide resident with a new call button bracelet, staff did not check on resident in a timely manner and visitors being denied entry into facility due to COVID are all unsubstantiated.

An exit interview was conducted with Amber Rodgers, Associate Executive Director and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC9099 (FAS) - (06/04)

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