374603126-12-13-2024-08-AS-SJAB-DC62HE-20241220162438

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603126
Report Date: 12/13/2024
Date Signed: 12/13/2024 03:48:51 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
03/22/2021 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20210322143050

FACILITY NAME:	VINTAGE RESIDENTIAL 1		FACILITY NUMBER:	374603126
ADMINISTRATOR:	GRAPE, CYNTHIA		FACILITY TYPE:	740
ADDRESS:	316 CRESTVIEW DRIVE		TELEPHONE:	(619) 271-3834
CITY:	BONITA	STATE: CA	ZIP CODE:	91902
CAPACITY:	6	CENSUS: 5	DATE:	12/13/2024
		UNANNOUNCED	TIME BEGAN:	01:15 AM
MET WITH:	Caregiver, Maria Rojas		TIME COMPLETED:	02:30 AM

ALLEGATION(S):

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Administrator threatened to evict resident
Administrator is not allowing essential medical visitors
Administrator is interfering with residents' medical care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to deliver investigative findings. LPA was greeted by Caregiver, Maria Rojas, to whom she identified herself and discussed the purpose of the visit. During the visit LPA spoke with Administrator, Cynthia Grape and explained the reason for the visit.

The Department investigated the above-listed complaint allegations. The investigation consisted of a tour of the facility, multiple interviews with staff, residents, and outside sources, and a detailed review of relevant records.

On March 22, 2021, Community Care Licensing (CCL) received a complaint alleging that the Administrator threatened to evict resident (R1). [a LIC 811 Confidential Names List was provided to staff to identify the resident] It was specifically alleged that on or about March 10, 2021, the Administrator informed R1 that they could not continue to live at the facility if they received medical care from an outside agency.
(Continue at LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2024

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-20210322143050

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VINTAGE RESIDENTIAL 1	FACILITY NUMBER: 374603126
	VISIT DATE: 12/13/2024

NARRATIVE

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(continue from LIC9099)

Interviews with R1 indicated that they were never served with an eviction notice. Multiple interviews with staff and outside sources consistently indicated they never witnessed the Administrator or any other staff member threatening R1 or any other resident they would get evicted if they received medical services from an outside agency. Detail review of resident records disclosed other residents living in the facility were receiving medical services from outside agencies. A detailed review of R1’s medical records indicated that R1 began receiving medical services from an outside agency on October 14, 2021. Multiple interviews with staff and outside sources disclosed that R1 continued to live at the facility under the care and supervision of an outside agency with coordinated care provided by facility staff. During multiple interviews with staff and outside sources, it was consistently stated that R1 voluntarily moved out on November 18, 2021, to another licensed facility of their choice. Multiple interviews with R1, staff and outside sources confirmed that the Administrator coordinated efforts with the outside agency to facilitate the relocation to a facility with the ability to provide higher level of care to meet R1’s needs. On December 12, 2024, CCL confirmed R1 was still living at the other licensed facility. The investigation did not yield supporting evidence to corroborate that the Administrator threatened to evict R1.

It was also alleged that the Administrator did not allow essential medical visitors. It was specifically alleged that the Administrator did not allow the outside agency to meet with R1 at the facility to discuss medical services. During multiple interviews with staff and outside sources, it was consistently indicated that the Administrator requested the outside agency personnel to coordinate appointments with facility staff before coming to the facility. This would avoid visitors showing up in large numbers at the same time which could potentially interfere with staff's ability to provide care and supervision to other residents in care. Staff also stated that they wanted to be present during medical care meetings to ensure they could coordinate services with the outside agency to meet R1's needs. During interviews, staff and residents consistently stated that they had never witnessed the Administrator or any other staff not allowing essential medical visitors for R1 or any other resident in the facility. In addition, a detailed review of the facility visitor logs for January, February, and March 2021 disclosed more than 160 visitors registered. The facility census was (4) residents this would equate to an average of 40 visitors per resident in 90 days. Based on the interviews and records reviews there was insufficient corroborating evidence found to support this allegation.

(continue at LIC9099C)

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2024

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20210322143050

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: VINTAGE RESIDENTIAL 1	FACILITY NUMBER: 374603126
	VISIT DATE: 12/13/2024

NARRATIVE

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(continue from LIC9099C)

Lastly, it was alleged that the Administrator interfered with R1’s medical care. It was specifically alleged that the Administrator insisted on being present during medical care meetings between R1 and the outside agency personnel. As stated in the prior allegation, during interviews, staff indicated they insisted on being present during medical care meetings because they wanted to be informed to ensure R1’s service care needs were being coordinated among both agencies. In addition, during interviews, R1 stated they wanted the Administrator to be present during care meetings to ensure their service care needs were being met

Based on the results of the investigation, which consisted of observations, interviews with staff, and outside sources, and a review of pertinent resident and facility records, there was insufficient evidence to support the allegations. Therefore, these allegations are deemed unsubstantiated. A finding that is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence that the alleged violation occurred.

An exit interview was conducted with Caregiver, Maria Rojas, to whom a copy of this report, Confidential Names List (LIC 811), and Licensee Appeal Rights (9058 03/22) were provided at the conclusion of the visit.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2024

LIC9099 (FAS) - (06/04)

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