374603437-6-5-2020-08-AS-SJAB-BR42QW-20200630173637

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603437
Report Date: 06/05/2020
Date Signed: 06/05/2020 01:44:50 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
03/17/2020 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20200317105205

FACILITY NAME:	SUNGARDEN TERRACE		FACILITY NUMBER:	374603437
ADMINISTRATOR:	LOVERDE, MELISSA		FACILITY TYPE:	740
ADDRESS:	2045 SKYLINE DRIVE		TELEPHONE:	(619) 462-5831
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	110	CENSUS: 50	DATE:	06/05/2020
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Melissa Loverde, Administrator		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Facility did not allow hospice to enter to visit resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA)Tiffany Holmes contacted the facility via tele virtual visit to close out a complaint investigation due to COVID-19. LPA identified herself and discussed the purpose of the call with Administrator, Melissa Loverde.

Investigation consisted of staff, and outside witness interviews and a records review. It was alleged facility did not allow hospice to enter to visit resident.
Interviews revealed Staff 1(S1) (see 811 LIC Confidential Names List) refused to let the Home Health Aides (HHA) into the facility due to S1 trying to limit the exposure and spread of Covid 19 to the residents. Interviews revealed that the HHA would come and give baths to residents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2020

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-20200317105205

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: SUNGARDEN TERRACE	FACILITY NUMBER: 374603437
	VISIT DATE: 06/05/2020

NARRATIVE

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S1 admitted that bathing services is an optional service from the HHAs and the staff at the facility could bathe the residents. S1 was fearful that the HHA travel to other facilities and could easily contract the Covid 19 and come back to their facility exposing the residents they would be working with.

Interviews with outside sources revealed that hospice nurses and other essential employees were let into the facility to provide wound care and other necessary services to the residents. Based on evidence obtained, there is insufficient evidence to determine facility did not allow hospice to enter to visit resident.

The Department investigated the allegation of facility did not allow hospice to enter to visit resident and was unable to meet the preponderance of the evidence standard to prove that the alleged violation occurred. Therefore, the above allegation is unsubstantiated.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2020

LIC9099 (FAS) - (06/04)

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