374603399-12-17-2024-18-AS-JDHS-DC5QBC-20241220110118

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603399
Report Date: 12/17/2024
Date Signed: 12/17/2024 11:25:12 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
12/11/2024 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20241211131929

FACILITY NAME:	WESTMONT OF ESCONDIDO		FACILITY NUMBER:	374603399
ADMINISTRATOR:	DAVID ALSPACH		FACILITY TYPE:	740
ADDRESS:	500 E VALLEY PKWY		TELEPHONE:	(760) 737-5110
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92025
CAPACITY:	200	CENSUS: 131	DATE:	12/17/2024
		UNANNOUNCED	TIME BEGAN:	11:11 AM
MET WITH:	Business Office Director, Tasha Keller		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Facility unlawfully evicted resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kathleen Banrasavong conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegation. LPA met with Business Office Director, Tasha Keller, where the LPA explained the purpose of the visit and the elements of the allegation. The investigation consisted of observations, interviews with staff members and residents, and a review of records.

On December 11, 2024, Community Care Licensing received a complaint alleging that Resident 1 (R1) was illegally evicted from the facility. It was alleged that the Administrator told R1 and their responsible party, that they could not return to the facility due to a change in R1’s condition. Information obtained from the interview with the Administrator indicated that the facility spoke to the Palomar Health Rehabilitation Institute, who informed the facility that R1 would need assistance with medication going forward.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-622-3619
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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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Control Number 18-AS-20241211131929

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: WESTMONT OF ESCONDIDO	FACILITY NUMBER: 374603399
	VISIT DATE: 12/17/2024

NARRATIVE

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Administrator spoke to R1 and their responsible party and relayed that R1 would need to be sent out each day for insulin injections or have a third-party company visit the facility to assist R1 with the insulin shots, at a cost of $150 to be paid by R1. Prior to this hospital visit, R1 managed their own medications. Administrator stated that they did not serve R1 with an eviction notice because R1 had not returned to the facility. Administrator stated that he would serve R1 with a 30-day eviction notice, as the facility is unable to meet R1’s needs. Information obtained from R1 admitted that they did use to manage their own medication and injections independently. After returning from the hospital visit, the facility conducted a reassessment, which revealed that R1 had a change in their level of care due to needing assistance with medication. R1 stated that they did not receive an official eviction notice. Information obtained from interviews with other pertinent parties corroborated that the facility did not serve R1 with a 3-day or 30-day eviction notice. During the course of the investigation, LPA verified that no eviction notices were generated for R1 or provided to R1 or their responsible party.

Based on the information obtained during the investigation, the allegation that the facility unlawfully evicted the resident has been deemed unfounded, meaning that the allegation was false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was discussed with and provided to Business Office Director, Tasha Keller.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: 951-622-3619
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC9099 (FAS) - (06/04)

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