374603136-9-2-2020-08-AS-JRAE-BTY7N8-20200930214818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603136
Report Date: 09/02/2020
Date Signed: 09/02/2020 01:49:58 PM

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
09/30/2019 and conducted by Evaluator Daniel Pena

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20190930081755

FACILITY NAME:	CORONADO RETIREMENT VILLAGE		FACILITY NUMBER:	374603136
ADMINISTRATOR:	ELIZABETH REYES		FACILITY TYPE:	740
ADDRESS:	299 PROSPECT PLACE		TELEPHONE:	(619) 437-1777
CITY:	CORONADO	STATE: CA	ZIP CODE:	92118
CAPACITY:	120	CENSUS: 64	DATE:	09/02/2020
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Elizabeth Reyes, Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility staff is financially abusing resident(s) in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced complaint visit via FaceTime due to Covid-19. LPA met with the Administrator, Elizabeth Reyes. The Administrator was interviewed regarding the allegation. The Department’s investigation included facility visits, resident and facility record reviews and interviews with Resident 1 (R1), staff and outside sources. (see LIC 811 Confidential Names List, for disclosure of staff and resident names).

It is alleged that on or about 09/24/2019, facility staff entered R1’s room and took the resident’s check book from a drawer and forced R1 to sign a check to the facility for $8000. Interviews confirmed that two staff met with R1. Staff went there to look for R1’s missing dentures which they found in R1’s room and returned to the resident. While in R1’s room, staff requested R1 to pay their rent as they had not made previous rent payments. The resident agreed and informed staff that R1 did not want to incorrectly enter the information on the check. R1 asked staff to fill out the check details, including the amount R1 owed. A staff member did as the resident requested and R1 provided their signature on the check. There were no independent witnesses divulged or identified who observed the incident.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2020

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-20190930081755

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: CORONADO RETIREMENT VILLAGE	FACILITY NUMBER: 374603136
	VISIT DATE: 09/02/2020

NARRATIVE

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(CONTINUED LIC9099):

During interviews, staff consistently denied they financially abused R1 or any resident. Outside source interviews also disputed the allegation that facility staff financially abused R1. A record review revealed the amount written on R1’s check (#1087) was $8031 which matched the amount entered on the facility invoice.

The Department has investigated the complaint alleging financial abuse by facility staff towards a resident in care. The Department has found that although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove the violation did or did not occur. Therefore, the allegation is determined as UNSUBSTANTIATED. An exit interview was conducted with Administrator Reyes and a copy of this report, Appeal and Licensee Rights (LIC 9058 01/16) and Confidential Names (LIC 811) were provided to Administrator Reyes via electronic mail. An electronic mail confirmation was requested to be sent by the Administrator upon receipt of the documents.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2020

LIC9099 (FAS) - (06/04)

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