374603190-8-8-2023-08-AS-LTEZ-CV5ULA-20230828154025

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603190
Report Date: 08/08/2023
Date Signed: 08/08/2023 02:44:54 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
09/06/2022 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20220906124939

FACILITY NAME:	ACTIVCARE AT BRESSI RANCH		FACILITY NUMBER:	374603190
ADMINISTRATOR:	MCDONALD, JASON		FACILITY TYPE:	740
ADDRESS:	6255 NYGAARD		TELEPHONE:	(760) 603-9999
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92009
CAPACITY:	80	CENSUS: 63	DATE:	08/08/2023
		UNANNOUNCED	TIME BEGAN:	02:04 PM
MET WITH:	Jason McDonald, Executive Director		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Licensee did not follow Covid-19 response requirements.
Licensee did not assist resident(s) with accessing medical care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced facility visit to deliver findings regarding the above-mentioned complaint allegation(s). LPA was welcomed by and identified herself to Jason McDonald, Executive Director.

On 9/6/22 it was alleged that the Licensee did not follow Covid-19 response requirements, and that the Licensee did not assist resident(s) with accessing medical care. The Department’s investigation involved 3 unannounced facility visits, interviews with relevant witnesses, and review of pertinent facility and outside source records.

Regarding the first allegation, " Licensee did not follow Covid-19 response requirements", it was alleged that facility staff would not administer Covid-19 tests to resident(s) unless they were presenting three (3) symptoms, even if a resident and/or family requested for a test to be administered.

(continued on LIC9099-C)

Substantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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-20220906124939

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ACTIVCARE AT BRESSI RANCH	FACILITY NUMBER: 374603190
	VISIT DATE: 08/08/2023

NARRATIVE

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(continued from LIC9099)

Staff interview revealed that residents were checked for common Covid-19 symptoms and a Med Tech or LVN would decide if a Covid-19 test should be administered. Staff interview revealed that Covid-19 tests would not typically be administered to residents with uncommon Covid-19 symptoms.

Outside source records review showed that staff declined to test a resident per family request because the resident was not showing 3 Covid-19 symptoms. Additionally, records showed that staff stated this was a public health rule. Outside source interview revealed that San Diego County Public Health did not have a "3-symptom" requirement for a resident or staff to be tested for Covid-19. Review of the facility's internal infection control document showed that the facility did not specify a minimum number of required symptoms in order for a resident or staff to be tested for Covid-19. Review of the facility's Mitigation plan called for testing upon symptoms and did not specify a minimum number of symptoms before a resident could be tested.

Outside source interviews corroborated that staff refused to test R1 and R2 for Covid-19, upon request, because they did not present with 3 symptoms. Interview revealed that staff stated the 3-symptom rule was a State requirement. Both residents in question were tested privately and/or 48 hours after request, and tested positive for Covid-19. Review of CCLD infection control guidelines related to Covid-19 did not show any protocol where 3 symptoms were required in order to test. Both interviews and record review support the allegation that the Licensee did not follow Covid-19 response requirements by refusing to test residents who did not present 3 Covid-19 related symptoms.

Regarding the second allegation, "Licensee did not assist resident(s) with accessing medical care", it was alleged that the Licensee's refusal to test residents for Covid-19 resulted in the delay of resident(s) receiving medical care. Outside source interview corroborated that staff's refusal to administer Covid-19 tests resulted in R1 and R2 being delayed in seeing their doctors for evaluation and time-sensitive treatment.

Based on interviews and records review, the preponderance of evidence has been met, and both allegations are therefore substantiated. Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC9099-D). A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with Jason McDonald, Executive Director, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220906124939

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ACTIVCARE AT BRESSI RANCH	FACILITY NUMBER: 374603190
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/08/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/08/2023 Section Cited CCR 87468.1(a)(2)	1 2 3 4 5 6 7	87468.1 Personal Rights of Residents in All Facilities: “(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful…accommodations…” This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	The administrator submitted the 2023 Infection Control Plan during the facility visit that specifies Covid-19 tests upon symptoms. Administrator provided certification that Covid-19 screening and testing will be conducted according to the most recent CCLD and CDPH guidelines.
	8 9 10 11 12 13 14	Based on records review and interviews, licensee did not accord safe, healthful accommodations to XXX out of XXX residents. This posed potential health and personal rights risks to persons in care.	8 9 10 11 12 13 14
Type B 08/08/2023 Section Cited CCR 87465(a)(1)	1 2 3 4 5 6 7	87465 Incidental Medical and Dental Care: “(a)(1) The Licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents”. This requirement is not met, as evidenced by:	1 2 3 4 5 6 7	The administrator agreed to follow the 2023 Infection Control Plan which states if a resident is Covid-19 positive, Staff will notify the resident's primary care physician of the results. Administrator provided certification to LPA during the facility visit.
	8 9 10 11 12 13 14	Based on records review and interviews, the Licensee did not assist in arranging medical care appropriate to the conditions and needs to 2 of 63 residents (R1, R2). This posed a potential health risk to persons in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC9099 (FAS) - (06/04)

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