374602062-8-24-2021-08-AS-SJAB-C6AVSF-20210827164129

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602062
Report Date: 08/24/2021
Date Signed: 08/24/2021 02:27:13 PM

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
02/28/2020 and conducted by Evaluator Lizzette Tellez

COMPLAINT CONTROL NUMBER: 08-AS-20200228170543

FACILITY NAME:	GOLDEN SUNSET RESIDENTIAL		FACILITY NUMBER:	374602062
ADMINISTRATOR:	MIGUEL A MALONE		FACILITY TYPE:	740
ADDRESS:	7541 MILKY WAY POINT		TELEPHONE:	(619) 564-2845
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92120
CAPACITY:	6	CENSUS: 4	DATE:	08/24/2021
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Administrator, Miguel Malone		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility unable to effectively communicate with residents
Licensee failed to provide appropriate accomodations
Facility is unsanitary

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Lizzette Tellez conducted an unannounced complaint visit to deliver findings on the above-mentioned allegations. LPA was met by Caregiver, Perla Martinez, and was granted entry into the facility. LPA spoke with Administrator, Miguel Malone, via phone and discussed the purpose of the visit.

The Department’s investigation consisted of interviews with staff, residents, and outside sources, review of records, and a tour of the facility. It was alleged that facility staff are unable to communicate effectively with residents. Interviews with staff and outside sources revealed that staff do not speak English, and instead rely upon gestures, verbal cues, and cellular telephone devices to translate exchanges with residents, visitors, and outside agencies. It was also discovered that many residents of the facility do not communicate in Spanish, and caregivers speak only Spanish or minimal English. Interviews revealed that the administrator or licensee advises outside agencies, including health agencies, to directly communicate with them and bypass staff regarding residents’ health needs or issues. Having staff present that speaks only Spanish impedes communication with residents, visitors, many who provide services to residents, and medical personnel in the event of an emergency. The Department was unable to interview relevant residents due to their cognitive limitations, or not being available for interview.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Lizzette Tellez	TELEPHONE: (619) 219-9755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

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 4

Control Number 08-AS-20200228170543

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: 08/24/2021

NARRATIVE

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It was alleged that the Licensee failed to provide appropriate accommodations. Investigation revealed that the facility has two full bathrooms. One bathroom is located in a shared bedroom, and another is in a common bathroom located in the hallway. Investigative interviews revealed that on or about December 2019, the toilet in the common bathroom was not working properly and residents had to use the bathroom located in the shared bedroom. Additionally, interviews revealed that although there are two full bathrooms in the facility, residents use the shower located in the shared bedroom for all showers. The only way to access this bathroom is by entering the shared bedroom. During the visit, LPA noted that there were two bathrooms in the facility, and both were operational at the time of the visit.

It was alleged that the facility is unsanitary. Investigation revealed that beginning on or around December 2019, when the toilet in the common bathroom was not fully functional, residents and staff were instructed to place soiled toilet paper in an open wastebasket. Staff confirmed that the wastebasket was emptied once it became full.

The Department has investigated the above-mentioned allegations and has found that, based upon the evidence gathered during the investigation, the preponderance of the evidence standard has been met, and the allegations are valid. Therefore, these allegations have been deemed substantiated.

These deficiencies are noted on the attached 9099-D, and are cited in accordance with the California Code of Regulations, Title 22. An exit interview was conducted with Mr. Malone and a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided to the Administrator via electronic mail. An electronic receipt of confirmation was requested to be sent by the Administrator upon receipt of the documents.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Lizzette Tellez	TELEPHONE: (619) 219-9755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 08-AS-20200228170543

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/24/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/24/2021 Section Cited CCR 87411(d)(3)	1 2 3 4 5 6 7	PERSONNEL REQUIREMENTS – GENERAL Skill and knowledge required to provide necessary resident care and supervision, including the ability to communicate with residents. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee stated a version of the Google Translate phone app with dictation is being implemented. He agreed to help staff download the app and practice with it, to the point that staff can be confident in its use. DEFICIENCY CLEARED PRIOR TO VISIT
	8 9 10 11 12 13 14	Based on interviews and LPA observations, facility staff did not speak English and were unable to communicate with residents, visitors, and outside agencies. This poses a potential health and safety risk to four of four residents in care.	8 9 10 11 12 13 14
Type B 08/24/2021 Section Cited CCR 87303(e)(6)	1 2 3 4 5 6 7	MAINTENANCE AND OPERATION Toilet, handwashing and bathing facilities shall be maintained in operating condition. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee stated the toilet in the shared bathroom was replaced. During today's visit, LPA observed the toilet to be working properly. CLEARED PRIOR TO VISIT
	8 9 10 11 12 13 14	Based on interviews, for approximately 7-8 weeks beginning in December 2019, the toilet in the facility's shared bathroom had a leak and was not working properly. This posed a health risk to residents in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Lizzette Tellez	TELEPHONE: (619) 219-9755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 08-AS-20200228170543

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/24/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/31/2021 Section Cited CCR 87303(a)	1 2 3 4 5 6 7	MAINTENANCE AND OPERATION The facility shall be clean, safe, sanitary and in good repair at all times. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee stated a trash can with lid would be purchased and will be used and trash will be emptied daily. Photo proof to be sent to CCL by POC date.
	8 9 10 11 12 13 14	Based on interviews, while the common bathroom’s toilet was not fully functional, soiled toilet paper was disposed of in an open wastebasket and emptied whenever the wastebasket became full. This posed a potential health risk to four of four residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Lizzette Tellez	TELEPHONE: (619) 219-9755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

LIC9099 (FAS) - (06/04)

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