374603182-2-23-2021-08-AS-RHEK-BYPA8N-20210228230012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603182
Report Date: 02/23/2021
Date Signed: 02/23/2021 03:34:48 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
10/03/2019 and conducted by Evaluator Dawn Segura

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20191003144841

FACILITY NAME:	RAMONA SENIOR MANOR		FACILITY NUMBER:	374603182
ADMINISTRATOR:	GALANG, MARJORIE C.		FACILITY TYPE:	740
ADDRESS:	1236 D STREET		TELEPHONE:	(760) 440-9844
CITY:	RAMONA	STATE: CA	ZIP CODE:	92065
CAPACITY:	28	CENSUS: 17	DATE:	02/23/2021
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Harris Jamil, Licensee		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Untrained staff are providing care and supervision.

Licensee is charging fees not listed in admission agreement.

Licensee is not conducting assessments of residents.

Staff are using inappropriate form of discipline.

Residents are being locked in rooms while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted a virtual visit, via video conferencing, to deliver investigative findings. LPA spoke with Harris Jamil, to whom she explained the reason for the virtual visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegations. The investigation consisted of a review of facility records and interviews with staff and outside sources.

In response to the first allegation, it was alleged that untrained staff are providing care and supervision to residents in care. During the course of the investigation, LPA reviewed staff training records maintained by the facility. Records of a random selection of caregiving and medication technician staff who work on the day and night shifts were reviewed. All five staff members whose records were reviewed had required training, and records maintained by the facility were up to date. Based upon the review conducted during the investigation, there was no evidence discovered to reflect that untrained staff were providing care and supervision to the residents.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

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-20191003144841

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: RAMONA SENIOR MANOR	FACILITY NUMBER: 374603182
	VISIT DATE: 02/23/2021

NARRATIVE

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The second allegation is that licensee charged fees that are not listed in the resident’s admission agreement. A review of fees charged to residents was conducted, and it was revealed that an additional fee was being assessed for one-on-one care to be provided to a resident (R3) [Licensee was provided an LIC 811 that identifies the resident]. During the investigation, it was determined that the additional care was needed because of R3’s high risk of falling. The facility’s admission agreement includes a provision that specifically provides for the assessment of additional fees for one-on-one care or supervision and nighttime help/care, if it is determined to be warranted. The investigation further revealed that R3’s responsible party was aware of the need for the increased care and agreed to the increase in service and fee. Based upon interviews conducted, the one-on-one care and fee increase for R3 were not initiated until proper consent had been obtained. The investigation did not yield any other residents who were assessed fees that were not listed in the admission agreement.

The third allegation is that assessments of residents have not been conducted. During the investigation, a review of resident files was conducted. Based upon the review of records, all resident files that were reviewed had an assessment that was conducted within the past twelve months. The investigative review did not reveal resident records that lacked the required assessment.

The fourth allegation is that residents are disciplined by putting difficult residents in bed at 5:00 or 5:30 PM. Interviews conducted revealed that some residents are put in bed relatively early; however, residents are not put in bed early because they are difficult. Interviews yielded that following dinner, which is usually served between 4:30 and 5:30 PM, residents are usually escorted to their rooms. Although some residents are escorted to their rooms and prepared for bed between 5:15 and 6:00 PM, interviews revealed that some residents are tired and ready to go to bed at that time. It was also noted that even if residents are escorted to their rooms early in the evening, residents are still permitted to remain up, if they are not ready to go to bed at that time. The investigation did not yield information to indicate or conclude that residents were being put to bed early as a form of discipline.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20191003144841

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: RAMONA SENIOR MANOR	FACILITY NUMBER: 374603182
	VISIT DATE: 02/23/2021

NARRATIVE

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The fifth allegation is that room doors have keys, and residents are being locked in the rooms. Based upon interviews conducted and LPA’s personal observation, doors to resident rooms were not observed to be equipped with locks that require a key to access. Resident room doors have a button that can be pushed from inside to lock the door, but residents have the ability to open the door from inside. The outside of the lock has a pin hole that can be used to unlock the door, if the door is accidentally locked. The investigation did not reveal any evidence of residents being locked inside rooms while in care.

Community Care Licensing has not obtained sufficient evidence to corroborate the above-listed complaint allegations. Based upon evidence gathered during the investigation, the allegations are unsubstantiated. This finding means that although the allegations may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with Harris Jamil, Licensee, via virtual visit, and copies of this report and Licensee/Appeal Rights (LIC 9058 01/16), were provided to the licensee via electronic mail. An electronic read receipt confirmation was requested to be sent by the licensee upon receipt of the documents.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

LIC9099 (FAS) - (06/04)

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