374602062-5-16-2024-08-AS-LTEZ-D5RU56-20240530151612

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602062
Report Date: 05/16/2024
Date Signed: 05/16/2024 12:49:55 PM

Unsubstantiated

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
08/27/2021 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-NP-20210827142059

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:	ZIP CODE:	92120
CAPACITY:	0	CENSUS: 0	DATE:	05/16/2024
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	N/A. Report Certified Mailed Licensee.		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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-Licensee did not maintain a healthful environment for resident.
-Facility staff took resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dang Nguyen concluded an investigation regarding the above prior complaint allegations. Since the facility closed on 01/23/2024 due to a Licensee-Initiated Closure, the allegation finding was delivered to Licensee via USPS certified mail.

The Complainant alleged that Licensee did not maintain a healthful environment for Resident #1 (R1), because about one month after moving in, R1 contracted scabies from their first roommate, and then about four months later, R1 contracted bed bugs from their second roommate. The Complainant also alleged that Licensee’s staff took/stole R1’s backpack and cell phone charger. CCLD’s investigation involved multiple unannounced facility tours / welfare checks and review of relevant care and administrative records. The Department also interviewed all current residents and pertinent staff and outside sources.

[CONTINUED ON LIC 9099-C, 1 of 2]

Unsubstantiated

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: 05/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024

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 3

Control Number 08-NP-20210827142059

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: GOLDEN SUNSET RESIDENTIAL	FACILITY NUMBER: 374602062
	VISIT DATE: 05/16/2024

NARRATIVE

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[CONTINUED FROM LIC 9099]

The Complainant and facility management agree that R1 moved in on 07/10/2019 with no sign of skin itching/irritation. Per R1’s LIC602 Physician’s Report (dated 07/10/2019) and their LIC603 Resident Appraisal (dated 07/09/2019) there was no mention of R1 having either bed bugs, scabies, or other skin problem at time of move in. About 1 month later, R1 first showed signs of itching. Upon recognizing this, Licensee contacted R1’s primary care physician (PCP), who prescribed a Permethrin 5% topical cream for seven days for treatment of scabies. The cream was effective in resolving R1’s itching. [The Complainant did not provide, nor did CCLD encounter during its investigation, any evidence of R1 ever having bed bugs while living at the facility.]

For the first month of R1’s stay at the facility, Resident #2 (R2) was with their roommate. This was followed by a period of almost nine months during which R1 had no roommate. Then from 05/04/2020 until R1 passed away on 07/19/2020, Resident #3 (R3) was their roommate. Per interview of facility administrator: Neither R2, R3, or any other housemate had either symptoms or diagnoses of either scabies or bed bugs, during the entire time R1 lived at the facility. (This was corroborated in interviews of 4 of 4 direct caregivers). R1’s PCP told Licensee that R1’s scabies could have been earlier present in/on their body, but dormant (i.e., without visible symptoms). [According to the federal Centers for Disease Control (CDC), “Scabies mites can live for as long as 1 to 2 months,” and in persons who have not had scabies before, “symptoms may take 4-8 weeks to develop.”]

Despite not having issues with bed bugs at the facility, Licensee nonetheless had proactively subscribed to and paid for monthly preventative pest control services via a third-party vendor/contractor (as invoices show). The vendor’s visit reports showed that during their August 2019 and September 2019 visits to the facility, they specifically treated R1’s room per Licensee’s request, despite finding “no [pest] deficiencies” in R1’s room or other areas of the facility. Manager interview also showed: Each resident in care, as a matter of protocol even before R1’s scabies incident, had their personal laundry washed separate from other residents’ laundry. Also, all residents’ mattresses were sealed in waterproof plastic, and incidentally, all had metal bed frames. Facility staff specifically disinfected R1’s bedframe.

[CONTINUED ON LIC 9099-C, 2 of 2]

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-NP-20210827142059

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: GOLDEN SUNSET RESIDENTIAL	FACILITY NUMBER: 374602062
	VISIT DATE: 05/16/2024

NARRATIVE

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[CONTINUED FROM LIC 9099-C, 1 of 2]

LPA performed two unannounced visits to the facility on 09/03/2021 and 10/12/2021, respectively. During both visits, LPA also performed a visual and tactile inspection of the bedsheets, pillowcases, and blankets of all five (5) residents remaining in care. Their bedrooms and common areas were clean. There were no signs of blood stains, dark or rusty spots, fecal spots, mite eggshells, shed skins, or musty or offensive odors on their bedding. The residents themselves appeared clean and well groomed, and each denied having itchy/irritated skin. LPA also spoke with another resident’s responsible person, who confirmed they had no concerns about facility cleanliness.

According to their signed LIC621 Resident Personal Property and Valuables Inventory (dated 07/09/2021), at time of move in, R1 and their responsible person (RP) did not declare R1 ever having a backpack or a cell phone charger. However, administrator interview showed that while R1 did not have a backpack, they did possess a cell phone charger while living at the facility. After R1 passed away on 07/19/2020 and their responsible person (RP) collected their few belongings, RP did not inform facility staff that they were unable to locate R1’s phone charger. It was not until CCLD commenced the complaint investigation on 09/03/2021 (i.e., over a year later) and inquired about R1’s cell phone charger, that Licensee first became aware that it was missing.

According to the facility’s running LIC9060 Theft and Loss Record: There was no mention of any missing item ever being reported for R1. Since that facility’s inception, there was only one (1) confirmed missing item reported by any other resident in care (i.e., a $35 sweater in December 2018). LPA interviewed four (4) direct care staff, all of whom said they did not think the facility had any theft problem. Of the five (5) remaining residents in care, only one (1) was able to be qualified as a reliable historian: They confirmed none of their personal property had been stolen while they lived at the facility. LPA also interviewed another responsible person, who confirmed they had no concerns about theft of resident belongings.

Based on interviews and records, a preponderance of evidence does not exist to prove that Licensee did not maintain a healthful environment for residents, or that its staff took/stole a residents’ personal belongings. Both complaint allegations are therefore Unsubstantiated. No deficiency was issued. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee via USPS certified mail.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024

LIC9099 (FAS) - (06/04)

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