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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374602832
Report Date: 09/14/2021
Date Signed: 09/14/2021 10:19:44 PM


Document Has Been Signed on 09/14/2021 10:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:LA VIDA DEL MARFACILITY NUMBER:
374602832
ADMINISTRATOR:WEST, LAURAFACILITY TYPE:
740
ADDRESS:850 DEL MAR DOWNS RDTELEPHONE:
(858) 755-1224
CITY:SOLANA BEACHSTATE: CAZIP CODE:
92075
CAPACITY:130CENSUS: 112DATE:
09/14/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Laura West, Executive DirectorTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analysts (LPA), Laarni Santiago and Alexandre Vo, conducted an unannounced Case Management Inspection to follow-up on previous incidents initiated on June 25, 2018. LPAs were allowed entry into the facility after identifying themselves and met with Business Manager, Scottie Geno, and Executive Director, Laura West. LPA explained the purpose of the visit.

The Department’s investigation included review of interagency reports and facility records, as well as, interviews with staff, residents, and outside sources.

The facility submitted self-reported incidents and SOC 341 received at the San Diego Regional Office on May 31st, 2018, June 19th 2018 and June 22nd 2018 regarding theft of residents’ credit/debit cards, unauthorized written checks and subsequent fraudulent charges on the residents’ financial accounts. Incident reports indicate that Resident #1 (R1, see List of Confidential Names) had a missing envelope containing of approximately $2,300.00. Resident #2 (R2) was reported to have unauthorized purchases of approximately $1,000.00. Resident #3 (R3) also reported unauthorized checks written for the amount of approximately $950.00 to an unrecognized individual. Resident #4’s (R4) reported a missing wallet during the same period that Suspect #1 (S1, see List of Confidential Names) was working at the facility. Furthermore, R4’s personal identification card was found in S1’s personal vehicle around September 2018.

Based on records and interviews, it was determined that S1 committed acts of fraudulence and theft against the financial welfare of elderly residents at the licensed community care facility. S1 assumed a family member’s identity and was hired on May 16th, 2018. S1 was terminated on July 11th, 2018. According to review of facility records and interviews, it was corroborated that S1’s employment timeline coincide with the fraudulent charges that occurred during their employment. S1 subsequently pleaded guilty to elder abuse violations on May 26, 2021 at San Diego County Superior Court that occurred between the time span of 2018-2019.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 318-5974
LICENSING EVALUATOR NAME: Laarni SantiagoTELEPHONE: (619) 318-5974
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: LA VIDA DEL MAR
FACILITY NUMBER: 374602832
VISIT DATE: 09/14/2021
NARRATIVE
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A citation is being issued in accordance with Health and Safety Code 1569.58 and listed on the LIC809D. A Plan of Correction was developed with the Executive Director and an exit interview was conducted. A copy of this report and Licensee’s Appeal Rights (9058 01/16) were provided to the Executive Director at the conclusion of the visit and her signature on this form confirms receipt of these documents.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 318-5974
LICENSING EVALUATOR NAME: Laarni SantiagoTELEPHONE: (619) 318-5974
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 09/14/2021 10:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108


FACILITY NAME: LA VIDA DEL MAR
FACILITY NUMBER: 374602832

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
10/14/2021
Section Cited

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Persons prohibited from … employment …
(a) The department may prohibit any person from … continuing the employment of, … any employee, …who has done any of the following:
(2) Engaged in conduct that is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility, or the people of the State of California.
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Based on records and interviews, S1 engaged in conduct that is inimical to the financial welfare of four of the 97 residents at the facility. This posed an immediate financial risk to residents in care.
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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: Simon JacobTELEPHONE: (619) 318-5974
LICENSING EVALUATOR NAME: Laarni SantiagoTELEPHONE: (619) 318-5974
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2021
LIC809 (FAS) - (06/04)
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