374601134-9-27-2024-08-AS-SJAB-DAJMXK-20241030100005

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601134
Report Date: 09/27/2024
Date Signed: 09/27/2024 12:56:00 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
08/22/2024 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20240822162042

FACILITY NAME:	SUNRISE AT LA COSTA		FACILITY NUMBER:	374601134
ADMINISTRATOR:	HERNANDEZ, MARLEN		FACILITY TYPE:	740
ADDRESS:	7020 MANZANITA ST		TELEPHONE:	(760) 930-0060
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	120	CENSUS: 92	DATE:	09/27/2024
		UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Executive Director Marlen Arguero Hernandez		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff did not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to deliver investigation findings. LPA was granted entry into the facility and met with Executive Director (ED) Arguero Hernandez , to whom she disclosed the reason for the visit.

Community Care Licensing (CCL) has investigated the above allegation. The investigation consisted of LPA observation, records review and interviews with facility staff and outside sources.

According to records review a LIC621 (Resident Personal Property and Valuables Inventory) was in R1's facility file however, the document was not completed. According to interviews with R1's responsible party (RP) the Licensee did not present the LIC621 document at time of move in or during contractual presentation. Therefore, no residential personal property and valuables were inventoried at time of move in.
(Continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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-20240822162042

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: SUNRISE AT LA COSTA	FACILITY NUMBER: 374601134
	VISIT DATE: 09/27/2024

NARRATIVE

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(Continued from 9099)

ED Arguero Hernandez tour showed that while R1 did have a myriad of bags in their room, the RP claims they are not the bags or items R1 brought into the facility at time of move in. During the 9/27/2024 tour LPA Rodgers accompanied by S1 and R1 looked through items in closet and discovered a few pieces of possible gold jewelry along with cosmetic jewelry. LPA Rodgers advised ED Arguero Hernandez to speak with R1's RP and encourage the RP to take home R1's the more valuable items for safe keeping.

Police report (dated 7/16/24 and 7/23/24) can not confirm or deny any items were taken from R1’s room. An OS1 was interviewed and was able to confirm they had no concerns about theft of residents belongs. According to the facility’s running Theft and Loss Records: There was no mention of any missing items reported over the last 12 months with the exception of R1's belongings.

Based on evidence obtained from interviews, observations and records reviewed, no corroborating evidence was obtained to indicate the facility failed to safeguard a client’s belongings.

Based on the Department's investigation there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with ED Arguero Hernandez to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) will be provided at the conclusion of today's visit.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC9099 (FAS) - (06/04)

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