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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602369
Report Date: 01/17/2023
Date Signed: 01/17/2023 02:55:23 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
02/26/2021 and conducted by Evaluator Daniel Pena
COMPLAINT CONTROL NUMBER: 08-AS-20210226095356
FACILITY NAME:GOLDEN LIVING HEALTH MANAGEMENT, INC.FACILITY NUMBER:
374602369
ADMINISTRATOR:ROCIO GRANDOLAFACILITY TYPE:
740
ADDRESS:3223 DUKE STREETTELEPHONE:
(619) 222-1109
CITY:SAN DIEGOSTATE: CAZIP CODE:
92110
CAPACITY:113CENSUS: 83DATE:
01/17/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Rocio Granda, AdministratorTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Staff does not properly assist a client while in care
INVESTIGATION FINDINGS:
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On January 17, 2023, at about 1:00 PM, Licensing Program Analyst (LPA) Daniel Pena conducted a complaint investigation visit regarding the above-mentioned allegation. LPA was greeted at the entrance by Rocio Granda, Administrator and granted entry after identifying himself and disclosing the reason for the visit. During today's visit, LPA conducted staff and client interviews and concluded the investigation. LPA met with Administrator Granda to discuss the findings of the complaint investigation.

It was alleged, facility staff does not properly assist a client in care, specifically regarding prescription medication. The Department’s investigation consisted of virtual and onsite visits, record reviews and interviews with clients, staff and outside parties.

Client interviews did not provide information corroborating the allegation that staff withheld or failed to administer prescription medication. Staff interviews revealed a consistent denial of withholding medications from clients. A review of facility and client records, including Medication Administration Records and client medication packages did not yield evidence to support the allegation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
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 2
Control Number 08-AS-20210226095356
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: GOLDEN LIVING HEALTH MANAGEMENT, INC.
FACILITY NUMBER: 374602369
VISIT DATE: 01/17/2023
NARRATIVE
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The Department has investigated the complaint that staff does not properly assist a client in care, specifically regarding prescription medication. Based upon the information gathered during this investigation; it is determined that although the incident may have happened and is valid, there is not a preponderance of evidence to prove it occurred and is therefore UNSUBSTANTIATED.

An exit interview was conducted, and the report was reviewed with Administrator, Granda. A copy of the report and Licensee Appeal Rights was provided to Administrator, Granda and her signature on this report confirms receipt of receiving the document.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2