374601395-10-25-2022-08-AS-LTEZ-CKN375-20221028175921

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601395
Report Date: 10/25/2022
Date Signed: 10/25/2022 05:10:59 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
07/30/2020 and conducted by Evaluator Dawn Segura

COMPLAINT CONTROL NUMBER: 08-AS-20200730164511

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: 42	DATE:	10/25/2022
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Brianna Iammarino, Director of Social Services		TIME COMPLETED:	10:42 AM

ALLEGATION(S):

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Facility staff financially abused resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigative findings. After introducing herself, LPA was granted entry into the facility and met with Brianna Iammarino, Director of Social Services, to whom she explained the purpose of the visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, review of facility records, and interviews.

It was reported to Community Care Licensing that a facility staff called Resident 1’s (R1) bank requesting a change of address and requested to set up online banking, so that R1’s bank statements could be received by the facility and the staff could have access to the resident’s information to view or make changes.

During the investigation, it was discovered that R1 moved into the facility in September 2019. A few months

Unfounded

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022

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-20200730164511

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: 10/25/2022

NARRATIVE

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after R1’s admission into the facility, R1 was in arrears in monthly payments. The investigation revealed that numerous attempts were made to communicate with R1’s responsible party in an effort to obtain outstanding payments. However, the facility’s attempts to collect payments were unsuccessful. Records reviewed during the investigation reflect that in June 2020, facility staff began to contact R1’s bank. Records further reflect that in July 2020, R1 agreed, in writing, to allow the facility to deduct funds from R1’s checking account each month as payment toward R1’s monthly payment and the outstanding balance.

Based upon evidence obtained during the investigation, attempts to gain access to R1’s account information and to set up online banking were done with R1’s knowledge in an effort to collect payments for R1’s living accommodations and to prevent the use of account funds for purposes outside of those authorized by R1. Accordingly, we have found that the complaint allegation was unfounded, meaning that the allegation was false, could not have happened, and/or is without a reasonable basis. Therefore, as to the above listed allegation, the facility is in compliance with Title 22 regulations at this time, and we have dismissed the complaint.

An exit interview was conducted with Brianna Iammarino, and copies of this report and Licensee Rights (LIC 9058) were provided to the Director of Social Services at the conclusion of the visit. Brianna Iammarino's signature on this report acknowledges receipt of copies of the rights and report.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2022

LIC9099 (FAS) - (06/04)

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