374602062-9-20-2023-08-AS-DPEA-CVUSZM-20230920141923

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602062
Report Date: 06/13/2023
Date Signed: 09/20/2023 02:19:23 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
03/26/2021 and conducted by Evaluator Daniel Pena

COMPLAINT CONTROL NUMBER: 08-AS-20210326102438

FACILITY NAME:	GOLDEN SUNSET RESIDENTIAL		FACILITY NUMBER:	374602062
ADMINISTRATOR:	MIGUEL A MALONE		FACILITY TYPE:	740
ADDRESS:	7541 MILKY WAY POINT		TELEPHONE:	(619) 794-2889
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92120
CAPACITY:	6	CENSUS: 2	DATE:	06/13/2023
		UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Maria Gonzalez, Caregiver		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

-Resident's care needs are not being met
-Resident's medication is not being administered properly
-Facility staff are not trained appropriately
-Facility unable to communicate with residents

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Daniel Pena conducted a complaint visit to the facility. LPA introduced and identified himself and explained the purpose of the visit to Caregiver, Maria Gonzalez. LPA was allowed into the facility. While at the facility, LPA spoke with Administrator, Malone on the facility telephone and informed him of the purpose of the visit.

The Department's investigation consisted of LPA observation during virtual and onsite facility inspections, review of facility/resident records, and interviews with staff and residents. LPA observation and interviews yielded insufficient evidence to determine resident's care needs were not met, resident's medication were not administered properly, staff was not trained appropriately nor unable to communicate with residents.

Based on the evidence obtained during this investigation, the preponderance of evidence standard was not obtained. Therefore, the allegations are determined to be Unsubstantiated. An exit interview was conducted with Staff, Gonzalez, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058 01/16) were provided, and their signature confirms receipt of the documents. This is an amended report for the visit on 6/13/2023.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2023

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 1