374602369-5-19-2022-08-AS-LTEZ-CEXUW7-20220531155613

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602369
Report Date: 05/18/2022
Date Signed: 05/19/2022 02:32:53 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
03/08/2022 and conducted by Evaluator Natasha Persaud

COMPLAINT CONTROL NUMBER: 08-AS-20220308080259

FACILITY NAME:	GOLDEN LIVING HEALTH MANAGEMENT, INC.		FACILITY NUMBER:	374602369
ADMINISTRATOR:	ROCIO GRANDA		FACILITY TYPE:	740
ADDRESS:	3223 DUKE STREET		TELEPHONE:	(619) 222-1109
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	113	CENSUS: 84	DATE:	05/18/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator, Rocio Granda		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit to conclude the complaint investigation regarding the above mentioned allegations. LPA met with Administrator, Rocio Granda.

During the investigation, LPA briefly toured the facility, obtained records, and interviewed staff and residents. It was alleged the facility was in disrepair due to a resident’s doorknob being broken and not locking. It was reported a resident’s doorknob was unable to lock for a period of three months and there were concerns there could be thefts. There are two residents residing in the room with the reported broken lock. Resident interviews confirmed the lock was never broken and the key entry always worked. Staff interviews revealed the doorknob was not reported as broken, but the resident was having difficulty opening the lock. Investigation revealed the doorknob was not broken, one of the two residents in that room was having difficulties unlocking the door due to a medical condition. Further staff interviews revealed once the issue was reported, the doorknob was replaced within 3 days. The facility removed the round doorknob and installed a doorknob with a handle to allow easier access for the resident with the medical condition. Continued on an LIC 9099C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

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-20220308080259

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 LIVING HEALTH MANAGEMENT, INC.	FACILITY NUMBER: 374602369
	VISIT DATE: 05/18/2022

NARRATIVE

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Administrator’s interview revealed once made aware the resident was having an issue opening the door, an order was placed with the maintenance staff to replace the doorknob. Administrator and residents confirmed the doorknob was never broken and the facility was not in disrepair. Administrator’s interview revealed once made aware the resident was having an issue opening the door, an order was placed with the maintenance staff to replace the doorknob. Administrator and residents confirmed the doorknob was never broken and the facility was not in disrepair.

Based on interviews, this agency has investigated the complaint alleging the facility was in disrepair. 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, Rocio Granda whose signature below confirms receipt of these rights

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

LIC9099 (FAS) - (06/04)

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