374601395-7-25-2022-08-AS-LTEZ-CGRUVH-20220728155511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601395
Report Date: 07/25/2022
Date Signed: 07/25/2022 01:36:02 PM

Unfounded

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
06/21/2022 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20220621082003

FACILITY NAME:	PARADISE VALLEY MANOR		FACILITY NUMBER:	374601395
ADMINISTRATOR:	AARON BURRUP		FACILITY TYPE:	741
ADDRESS:	2575 E. EIGHTH STREET		TELEPHONE:	(619) 470-6700
CITY:	NATIONAL CITY	STATE: CA	ZIP CODE:	91950
CAPACITY:	50	CENSUS: 37	DATE:	07/25/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Assisted Living Wellness Director Cecy Salomon		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff confiscated resident's personal property.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced subsequent visit, to deliver a finding regarding the above prior complaint allegation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Assisted Living Wellness Director Cecy Salomon.

It was alleged that licensee confiscated Resident #1 (R1)’s cell phone, because licensee required them to rely on its provided landline phone instead. CCLD’s investigation consisted of an unannounced facility tour/welfare check, review of the facility’s theft/loss records, and interviews of pertinent residents, facility staff, and outside sources.

The investigation revealed that R1’s cell phone was lost, but it was never confiscated by staff. According to a written Theft and Loss report provided by licensee, R1 told staff on 06-02-2022 that their cell phone was missing. Staff unsuccessfully searched R1 and their roommates’ beds, closets, trash cans, and bathroom, as well as the facility laundry room, linen closets, and housekeeping carts. [CONTINUED ON LIC 9099-C]

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022

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 2

Control Number 08-AS-20220621082003

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: PARADISE VALLEY MANOR	FACILITY NUMBER: 374601395
	VISIT DATE: 07/25/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

[CONTINUED FROM LIC 9099]

R1 themselves told LPA that their cell phone was stolen by an unknown person, but it was not confiscated by staff on the basis of some facility policy. R1’s conservator insisted R1 misplaced/lost their cell phone, as opposed it being stolen. (The conservator said they left service to the cell phone active for a full month after the date of loss and verified with the cell service provider that not a single phone call was made on it during that time.)

Beyond interviewing R1, LPA also surveyed 4 resident peers and 4 direct care staff. All persons interviewed confirmed that if a resident owns a cell phone to begin with, they can keep it. All residents interviewed confirmed facility staff have never tried to confiscate their personal property.

Based on records and interviews, the allegation that licensee confiscated R1’s cell phone is unfounded, meaning it was false, could not have happened, and/or is without a reasonable basis. We have therefore dismissed the allegation. An exit interview was conducted with the Salomon, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2