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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603165
Report Date: 03/27/2024
Date Signed: 03/27/2024 08:40:40 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
12/22/2020 and conducted by Evaluator Nacole Patterson
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20201222154453
FACILITY NAME:SILVERADO SENIOR LIVING - ENCINITASFACILITY NUMBER:
374603165
ADMINISTRATOR:JOHNSON, MARIVELFACILITY TYPE:
740
ADDRESS:335 SAXONY RDTELEPHONE:
(760) 753-1245
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY:0CENSUS: 0DATE:
03/27/2024
UNANNOUNCEDTIME BEGAN:
06:00 PM
MET WITH:Facility closed-emailed to last known addressTIME COMPLETED:
08:40 PM
ALLEGATION(S):
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Resident is not allowed to communicate freely with family.
INVESTIGATION FINDINGS:
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The following determination of findings has been made by Licensing Program Analyst (LPA) Nacole Patterson regarding the above allegation. The facility closed on March 3rd, 2021, due to a change of ownership, and this report was mailed to the last known address on record for the former licensee regarding the findings.

On 12/22/2020 it was alleged that a resident (R1) was not allowed to communicate freely with family. The Department’s investigation consisted of a virtual facility visit (due to Covid-19 restrictions), review of relevant records, and interviews with facility staff and outside sources. Staff interviews revealed that during the time of the complaint, the facility scheduled and monitored visitation due to Covid-19. Interview with the Administrator revealed that staff remained nearby during visits to ensure that infection control protocols were followed.

(Continued on LIC9099-C p.2)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024
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 08-AS-20201222154453
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: SILVERADO SENIOR LIVING - ENCINITAS
FACILITY NUMBER: 374603165
VISIT DATE: 03/27/2024
NARRATIVE
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(Continued from LIC9099 p.1)

While the information gathered during staff interviews indicated that staff may have stood close by during R1's visit, the justification was due to a facility-wide policy, supported by CCLD PIN recommendations, that had been communicated to families in writing and corroborated by review of records. Additional staff interview revealed opinions from staff that the Licensee made every effort possible, within guidelines, to ensure visitation/communication was maximized for residents and their families. Staff interviews did not give corroborating evidence that R1's visits/communication was restricted.

Interviews with staff and an Outside Individual (OI) revealed that the family member in question did not receive all facility communication because they were not R1's Responsible Party. Additional outside sources did not respond for interview. Due to their baseline memory loss, R1 was unable to participate as a reliable historian/interviewee regarding the allegation.

Records review revealed weekly email communication by the Administrator to the community on June 22nd 2020, and from September 3rd 2020 to December 29th 2020 regarding Covid-19 updates and protocols. Each email included visitation policy/protocol updates that were consistent with CCLD PIN recommendations for visitation during that time. No records were found to corroborate that the visitation/communication policies were specific to R1 or their family. On the contrary, the records revealed that the facility made attempts to offer visitation for residents in multiple ways such as in person, indoor, outdoor, virtually, while in isolation, and through social media. Review of a Department Provider Information Notice (PIN) 20-38-ASC, which was in effect during the timeframe of the complaint, allowed for facilities to restrict/limit visitation without a waiver due to the state of emergency. The PIN outlined when facilities must allow and restrict visitation under specific circumstances. The information was consistent with the evidence found regarding visitation procedures at the facility.

Based on interviews and records review, the investigation did not yield sufficient evidence to conclude that the resident was not allowed to communicate freely with family, therefore the allegation is UNSUBSTANTIATED. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were mailed to the last known address on file for the facility.
SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2