374601107-7-19-2022-08-AS-JRAE-CGRVLJ-20220728163202

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601107
Report Date: 07/19/2022
Date Signed: 07/19/2022 11:20:56 AM

Substantiated

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
01/24/2022 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20220124095057

FACILITY NAME:	GALE'S GARDEN		FACILITY NUMBER:	374601107
ADMINISTRATOR:	NICOLE MORA		FACILITY TYPE:	740
ADDRESS:	1127 GALE STREET		TELEPHONE:	(760) 745-6844
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92027
CAPACITY:	4	CENSUS: 0	DATE:	07/19/2022
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:			TIME COMPLETED:	11:21 AM

ALLEGATION(S):

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Unlawful Eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano sent this report to the former licensee at their last known mailing address via USPS certified mail and via email to deliver the investigation findings for the above allegation. The facility ceased operations on or about 2/18/22.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of LPA’s review of records, interview with facility staff, and outside sources.

It was alleged that the licensee did not allow the resident to return to the facility (R1) [an LIC 811 Confidential Names List was provided to the facility representative to identify the resident] Records review revealed that on January 21, 2022 R1 was sent to the hospital after hitting their head on a wall. Interview with outside agency revealed Licensee was contacted on January 22, 2022 advising that R1 was able to return to the facility. The only change was that R1 needed assistance applying their eye drops. Licensee was adamant that they could not accept R1 back. (Continued on LIC9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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-20220124095057

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: GALE'S GARDEN	FACILITY NUMBER: 374601107
	VISIT DATE: 07/19/2022

NARRATIVE

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Licensee advised outside agency that the facility was closing and that they could no longer provide R1 with the level of care that R1 required. The Licensee was contacted several more times and R1 remained at the hospital for five days until they were ultimately placed at a Skilled Nursing Facility.

Interview with R1’s responsible party (RP) revealed that they were aware of the trouble the licensee was having, trying to find new placement for R1. RP stated that although they were advised by the licensee that she intended to close the facility, they were never issued a 30-day eviction notice for R1.

Interview with Licensee revealed that on September 1, 2021 she advised both R1 and their responsible party of her intention to close the facility, as soon as she found R1 new placement. Licensee stated that the abrupt facility closure was due to a personal family reason. Licensee further stated that she had been working in conjunction with R1’s Physician attempting to find new placement for the only remaining resident (R1). Licensee stated that no facility would accept R1 due to the level of care that R1 required and R1 was only able to pay less than one thousand dollars a month. Licensee further stated that a referral agency staff member suggested that R1 go to a hospital and they would place R1 at a Skilled Nursing Facility. Licensee stated that she tried to find new placement for R1 for several months without any success and did not have any other options. Licensee stated that although she advised R1 and their responsible party of her intent to close the facility, she never issued a 30-day eviction notice.

Based upon interviews conducted and records review, the above allegation is substantiated. This finding means that the preponderance of the evidence standard has been met and the allegation is valid. Deficiency is cited in accordance with California Code of Regulations, Title 22, 87224(a)(4) as noted on the attached LIC 9099-D. A copy of this report along with Licensee/Appeal Rights (LIC 9058) was mailed via USPS Certified Mail to the former licensee’s mailing address on file.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20220124095057

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: GALE'S GARDEN	FACILITY NUMBER: 374601107
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/19/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/19/2022 Section Cited CCR 87224(a)(4)	1 2 3 4 5 6 7	The licensee may evict a resident for one or more of the reasons listed...Thirty (30) days written notice to the resident is required, If, after admission, it is determined that the resident has a need not previously identified...and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Deficiency cleared on this date as evidenced by facility closure, effective 2/18/22
	8 9 10 11 12 13 14	Based on interviews and record review the licensee did not provide thirty (30) days written notice to evict 1 in 1 of 1 persons in care (R1) which posed a potential safety and personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

LIC9099 (FAS) - (06/04)

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