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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602608
Report Date: 05/23/2023
Date Signed: 05/23/2023 03:35:52 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2023 and conducted by Evaluator Tricia Danielson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20230516085122
FACILITY NAME:SAILS ALEXANDERFACILITY NUMBER:
374602608
ADMINISTRATOR:KAITLN CORLEYFACILITY TYPE:
735
ADDRESS:301 JOHAH RDTELEPHONE:
(760) 233-4036
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:4CENSUS: 4DATE:
05/23/2023
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Hector Padilla, AdministratorTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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9
Facility has insufficient staffing to meet resident’s needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tricia Danielson arrived unannounced to the facility to initiate an investigation into the allegation list above. LPA met with Administrator Hector Padilla and explained the purpose of the visit.
During today's visit, LPA toured the facility, reviewed and obtained copies of pertinent records, and interviewed five (5) staff. Regarding the allegation "Facility has insufficient staffing to meet resident's needs", it was alleged that the facility did not have enough staff work the NOC shift to provide proper supervision due to the activity of one particular resident. Interviews conducted with five (5) staff indicated Resident #1 (R1) can be active for NOC shift staff but not always. All five (5) staff reported R1 either stays awake late at night or rises early in the morning for the NOC shift staff. All five (5) staff reported Resident #2 (R2) is a very early riser and requires monitoring while using the bathroom. Three (3) of five (5) staff interviewed reported they have no troubles meeting all resident's needs while working the NOC shift. Review of the staff schedule indicated there are two (2) staff scheduled each NOC shift on Wednesday, Thursday, Friday, and Saturday. Currently, only Staff #1 (S1) is scheduled to work on Sunday, Monday, and Tuesday NOC shift. Per S1, other
(CONTINUED ON LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Tricia Danielson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023
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 18-AS-20230516085122
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SAILS ALEXANDER
FACILITY NUMBER: 374602608
VISIT DATE: 05/23/2023
NARRATIVE
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(CONTINUED FROM LIC9099-C)
staff have been filing in on those days to provide coverage until a new staff is hired. Review of Appraisal/Needs and Services Plan and Individual Program Plan for R1 and R2 do not indicate either one requires direct supervision overnight. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted and copy of this report was provided along with LIC811- Confidential Names list.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Tricia Danielson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2