374603339-2-26-2024-18-AS-JDHS-D2VRNH-20240228121017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603339
Report Date: 02/26/2024
Date Signed: 02/26/2024 03:17:49 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE AC/SC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/24/2024 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20240124163406

FACILITY NAME:	MERIDIAN AT LAKE SAN MARCOS, THE		FACILITY NUMBER:	374603339
ADMINISTRATOR:	FERLINA MCBRIDE		FACILITY TYPE:	740
ADDRESS:	1177 SAN MARINO DR BLDG 1 & 2		TELEPHONE:	(760) 510-7500
CITY:	SAN MARCOS	STATE: CA	ZIP CODE:	92078
CAPACITY:	170	CENSUS: 135	DATE:	02/26/2024
		UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Executive Director, Amy Banaga		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility failed to report financial abuse to Licensing

INVESTIGATION FINDINGS:

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On 01/24/2024, Community Care Licensing (CCL) received a complaint that alleged the facility failed to report financial abuse to Licensing. During the course of the investigation, LPA interviewed the Administrator, Amy Banaga. Banaga stated that she submitted the Unusual Incident/ Injury Report to the Regional Office. Administrator indicated that the incident occurred on 01/17/2024 and it was reported on 01/17/2024. LPA reviewed the serious incident report that was submitted to the regional office. LPA reviewed the facility log of serious incident reports and the serious incident report was not logged. However, it is unreasonable to state that the facility did not report the incident. There are currently no concerns regarding the facility reporting incident to the regional office.
Based on LPA’s observation, interview conducted, and record reviews, the preponderance of evidence shows that the allegations that facility failed to report financial abuse to Licensing. The Department has found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-248-0319
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2024

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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