374603136-5-27-2021-08-AS-SJAB-C3KSUW-20210601141149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603136
Report Date: 05/27/2021
Date Signed: 05/27/2021 03:07:20 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
05/20/2021 and conducted by Evaluator Lizzette Tellez

COMPLAINT CONTROL NUMBER: 08-AS-20210520105327

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: 53	DATE:	05/27/2021
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Administrator, Liz Reyez		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff are not conducting planned activities for residents at facility
Notice of planned activities not posted in central location at facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Lizzette Tellez conducted an unannounced complaint visit to investigate the above-mentioned allegations. LPA was met by Liz Reyes, Administrator, and was allowed entry into the facility. LPA met with Ms. Reyes and discussed the purpose of the visit.

Investigaton consisted of interviews, record review, and a tour of the facility. It was alleged that staff are not conducting planned activities for residents at the facility, and that there is no notice of the planned activities posted in a central location at the facility. An activities area was observed and was stocked with activities supplies, including arts and crafts supplies, cooking supplies, board and card games, video games, musical instruments, exercise equipment, and audio/video equipment. An outdoor gardening area was also observed. There was a white board with the daily calendar of activities in the lobby. An activities calendar for the month of June 2021 was observed in a common hallway, which is accessible to all residents in care. Interviews with staff and residents did not support the allegations. Interviews revealed that there is a full-time activities director employed by the facility and there are varied activities conducted on site and off site.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Lizzette Tellez	TELEPHONE: (619) 219-9755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021

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-20210520105327

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: 05/27/2021

NARRATIVE

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The Department has investigated the above-mentioned allegations and based on LPA observations, interviews, and record review has found that the complaint was unfounded, meaning that the allegations were false, could not have have happened and/or are without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Ms. Reyes and a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided to the Administrator via electronic mail. An electronic receipt of 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: Lizzette Tellez	TELEPHONE: (619) 219-9755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021

LIC9099 (FAS) - (06/04)

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