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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602252
Report Date: 03/29/2023
Date Signed: 03/29/2023 04:55:45 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
03/23/2023 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20230323102720
FACILITY NAME:OCEANSIDE REST HOME IIFACILITY NUMBER:
374602252
ADMINISTRATOR:SIERA NAVASAKFACILITY TYPE:
740
ADDRESS:15 SHASTA COURTTELEPHONE:
(760) 722-8503
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:6CENSUS: 6DATE:
03/29/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator, Siera NavasakTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Financial abuse of resident by a facility employee
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and was allowed entry into the facility by staff, Candy Tamayo. Administrator, Siera Navasak arrived during the visit and discussed the allegation mentioned above with LPA.

During tthe investigation, a tour of the facility was condcuted along with staff intervews. It was alleged Resident #1 (R1) was financially abused by a facility employee. Interviews with staff and residents revealed R1 does not reside at the facility and never has.

This agency has investigated the complaint alleging financial abuse of resident by a facility employee. Based on interviews, we have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Administrator, Siera Navasak whose signature below confirms receipt of these rights.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
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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