374603236-4-25-2023-08-AS-LTEZ-CRC3JF-20230428181727

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603236
Report Date: 04/25/2023
Date Signed: 04/25/2023 12:47:31 PM

Unsubstantiated

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
02/13/2023 and conducted by Evaluator Rebecca A Ruiz

COMPLAINT CONTROL NUMBER: 08-AS-20230213143754

FACILITY NAME:	ROXIES ELDERLY HOMES I		FACILITY NUMBER:	374603236
ADMINISTRATOR:	TERESITA ROXAS		FACILITY TYPE:	740
ADDRESS:	290 HOLIDAY WAY		TELEPHONE:	(760) 722-5920
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92057
CAPACITY:	6	CENSUS: 5	DATE:	04/25/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Teresita "Roxie" Roxas		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Staff handled resident(s) in a rough manner
Licensee did not treat resident(s) with dignity
Licensee did not allow visitation at the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegations. LPA identified herself to, was greeted by, and explained the purpose of the visit to Licensee Teresita "Roxie" Roxas.

The Department’s investigation consisted of interviews with residents, staff, and outside sources, records review, and a tour of the facility. It was alleged that staff handled resident(s) in a rough manner, the Licensee did not treat resident(s) with dignity, and the Licensee did not allow visitation at the facility. Interviews and records review revealed that 5 of 5 residents required assistance with bathing and received showers either daily from facility staff or every other day from outside agencies. Interviews revealed that facility staff assisted residents with showers everyday or provided residents with bed baths on days where residents did not receive showers.

Continued on LIC9099-C page...

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

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-20230213143754

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: ROXIES ELDERLY HOMES I	FACILITY NUMBER: 374603236
	VISIT DATE: 04/25/2023

NARRATIVE

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Interviews revealed that some residents had instances of not wanting to shower and staff would attempt to redirect residents by talking to them. Interviews did not reveal any concerns regarding staff treating residents roughly during showers. Interviews revealed that staff attempt to accommodate residents’ preferences regarding meal times, types of meals prepared and showering times. Interviews did not reveal any issues or concerns with the staff treating residents without dignity.

Interviews and records review revealed that the Licensee set visiting hours for the facility from about 8:00am to 3:00pm. Interviews revealed that the Licensee requested that visitors leave the facility around 3:00pm because there was not enough staff to manage visitation. Interviews and record review revealed that there are two staff scheduled for the AM shift, which is from 6:30am to 12:00pm and one staff scheduled for the PM shift, which is from 12:00pm to 4:00pm. Interviews and records review revealed that the Licensee lived at the facility and was the only staff responsible for care and supervision for residents from 4:00pm to 6:30am every day. Interviews revealed that visitors were able to visit with residents and most residents had daily or weekly visitors. Interviews did not reveal any issues with visitors being unable to visit the facility. Interviews did confirm that the Licensee asked visitors to visit the facility prior to 3:00pm. Interviews revealed that the Licensee stated that she would make exceptions for visitors who were unable to visit prior to 3:00pm, but would still ask that visitors refrain from visiting past 4:00pm.

The Department has investigated the above-mentioned allegations and based on interviews and records review, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated.

An exit interview was conducted with Licensee Teresita "Roxie" Roxas, to whom a copy of this report and the Licensee Appeal Rights (LIC9058 01/16) were provided via hard copy.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

LIC9099 (FAS) - (06/04)

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