374601685-6-20-2024-08-AS-RSTS-D6NSBM-20240628134412

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601685
Report Date: 06/19/2024
Date Signed: 06/20/2024 08:39:57 AM

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
07/23/2021 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20210723092920

FACILITY NAME:	REGENCY FALLBROOK		FACILITY NUMBER:	374601685
ADMINISTRATOR:	RIDENOUR, JASMINE		FACILITY TYPE:	740
ADDRESS:	609 E.ELDER STREET		TELEPHONE:	(760) 728-8504
CITY:	FALLBROOK	STATE: CA	ZIP CODE:	92028
CAPACITY:	75	CENSUS: 62	DATE:	06/19/2024
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Administrator Kari Moreno		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Licensee does not implement safety measures.
Licensee does not provide adequate food service.
Facility is in disrepair.
Staff does not receive adequate training.
Staff fails to report to Licensing.
Admission Agreement does not meet Licensing requirements.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to conclude a complaint investigation regarding the above-mentioned allegations. LPA Correia met with Administrator Kari Moreno, identified herself, and explained the purpose of the visit.

The Department’s investigation consisted of resident interviews, a facility tour, and a facility records and file review.

It was alleged the Licensee did not implement safety measures. A facility tour revealed toxins and dangerous items were in locked areas/cabinets and inaccessible to residents in care. Smoke alarms and carbon monoxide detectors were operable, and fire extinguishers were present and current. A facility records review also revealed an approved infection control plan, disaster drills were being conducted per protocol. Interviews with residents also revealed no safety concerns at the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 380-3797
LICENSING EVALUATOR NAME: Debbie Correia	TELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

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-20210723092920

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: REGENCY FALLBROOK	FACILITY NUMBER: 374601685
	VISIT DATE: 06/19/2024

NARRATIVE

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It was alleged the Licensee did not provide adequate food service. A facility record review revealed the facility maintains a weekly menu with nutritional meals. Interviews conducted with residents revealed being happy with the meals offered at the facility. Resident interviews also revealed the kitchen staff are very accommodating and offer substitute food when requested.

It was alleged the facility is in disrepair. The facility tour also revealed the facility was well kempt and in good repair. The facility carpets were observed to be clean and in good condition, furniture and fixtures were also observed to be in good repair. The facility’s ambient temperature at the time of visit was between 74 degrees and 77 degrees Fahrenheit. A facility records review dated May 31, 2021, revealed having a contract with an outside source agency that provides ongoing maintenance to the facility central air conditioning/heating units as needed. Interviews conducted with residents had no complaints regarding the issues, such as disrepair, with the facility’s physical plant.

It was also alleged facility staff did not receive adequate training and the Licensee failed to meet Licensing reporting requirements. A facility records review revealed staff are provided the appropriate training based on hired position. A records review did not reveal any evidence supporting failure to meet reporting requirements.

Lastly, it was alleged the content of the facility's Admission Agreement did not meet Licensing requirements. A facility records review did not support the allegation.

Based on the Department's investigation, there was not a preponderance of evidence to prove the alleged violations occurred, therefore the allegations are unsubstantiated. An exit interview was conducted with Administrator Moreno to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) will be provided at the conclusion of the visit. Signature below confirms receipt of the reports.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 380-3797
LICENSING EVALUATOR NAME: Debbie Correia	TELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC9099 (FAS) - (06/04)

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