374603444-6-4-2024-08-AS-SJAB-D6DK8G-20240619074040

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603444
Report Date: 06/04/2024
Date Signed: 06/04/2024 01:00:15 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
05/31/2024 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20240531101047

FACILITY NAME:	OPALEC BOARD AND CARE		FACILITY NUMBER:	374603444
ADMINISTRATOR:	LEANN COX OPALEC		FACILITY TYPE:	740
ADDRESS:	5638 PLUMAS STREET		TELEPHONE:	(619) 434-6366
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92139
CAPACITY:	6	CENSUS: 6	DATE:	06/04/2024
		UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Licensee Lilia Opalec		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff inappropriately restrained resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced complaint visit to investigate a complaint regarding the above mentioned allegation. LPA was greeted and granted entry by Lilia Opalec, Licensee, and the purpose of today's visit was disclosed.

During today’s visit, LPA toured the facility, observed residents in care, reviewed and obtained copies of facility records, and interviewed residents and the Licensee. The facility is licensed to serve six (6) elderly residents, all of whom may be non-ambulatory. A hospice waiver is approved for three (3) residents and the facility is in compliance with the hospice waiver requirements.

On May 30, 2024, Community Care Licensing (CCL) received a complaint alleging inappropriatly restraint to Resident #1.(R1) resulted in R1 barricaded in their beds by full bed rails.

[Continued on 9099-C]

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 5

Control Number 08-AS-20240531101047

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: OPALEC BOARD AND CARE	FACILITY NUMBER: 374603444
	VISIT DATE: 06/04/2024

NARRATIVE

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[Continued on LIC9099-C].

During the investigation, LPA Rodgers collected pertinent resident records as well as facility documentation, conducted interviews as well as contacting two hospice care facilities to acquire documents. Observation by LPA Rodgers visit revealed full bed rails were on R1 bed. Interviews with staff confirmed full bed rails (2 half rails to make a whole bed rail) have been used since move in date of R1. A records review with Hospice organization (dated March 22, 2024) and Physican's report (dated March 2024) revealed there are no orders in place for full bed rails.

The Department has investigated the above-mentioned allegation and based on interviews, record review, and observations, the preponderance of the evidence has been met, therefore, this allegation is deemed substantiated. The following deficiency is cited per CA Code of Regulations Title 22 and noted on the attached LIC9099-D page.

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

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
05/31/2024 and conducted by Evaluator Amy Rodgers

COMPLAINT CONTROL NUMBER: 08-AS-20240531101047

FACILITY NAME:	OPALEC BOARD AND CARE		FACILITY NUMBER:	374603444
ADMINISTRATOR:	LEANN COX OPALEC		FACILITY TYPE:	740
ADDRESS:	5638 PLUMAS STREET		TELEPHONE:	(619) 434-6366
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92139
CAPACITY:	6	CENSUS:	DATE:	06/04/2024
		UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Lilia Opalec, Licensee		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff spoke to resident in an inappropriate manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced complaint visit to investigate a complaint regarding the above mentioned allegation. LPA was greeted and granted entry by Lilia Opalec, Licensee, and the purpose of today's visit was disclosed.

During today’s visit, LPA toured the facility, observed residents in care, reviewed and obtained copies of facility records, and interviewed residents and the Licensee.

The Complainant alleged that Licensee inappropriately spoke to Residentt #1 (R1). [See LIC811 Confidential Names List for a description of S1.] CCLD’s investigation involved an unannounced facility tour/welfare check, finding all Residents in care were safe/uninjured. LPA collected copies of and reviewed pertinent care records. LPA also interviewed 3 of 6 clients in care (to include C1), 2 of 3 direct care staff and an outside source.
[continued on 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 08-AS-20240531101047

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: OPALEC BOARD AND CARE	FACILITY NUMBER: 374603444
	VISIT DATE: 06/04/2024

NARRATIVE

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[Continued from 9099]

According to S1’s LIC602 Physician’s Report (dated 05//2024): C1 has a Diagnosis of Dementia. Their doctor determined that C1 is only oriented to self only, able to follow instructions, able to communicate her needs.
C1 demonstrated to LPA that they were not oriented to place, and time. However, is aware of likes and dislikes and makes the needs known to staff. LPA observations and interviews revealed staff conducts themselves in a professional manner and treats residents with dignity and thoughtfulness. LPA did not encounter allegations or evidence of S1 or other staff treating residents without respect.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

An exit interview was conducted with Licensee Lilia Opalec. Appeal Rights (LIC 9098 01/16) along with a copy of this report was provided to Licensee Lilia Opalec and their signature on this form confirms receipt of these rights.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2024

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20240531101047

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: OPALEC BOARD AND CARE	FACILITY NUMBER: 374603444
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/04/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/04/2024 Section Cited CCR 87608(a)(5)(B)	1 2 3 4 5 6 7	B) Bed rails that extend the entire length of the bed are prohibited except for residents who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee removed the the lower half bed rail (which made a full rail) and will attend Postural Support training. Proof of training due by POC due date. 7/3/2024.
	8 9 10 11 12 13 14	Based on observation, the licensee did not comply with the section cited above in 1 out of 3 residents did not have a hospice care plan that specified a full bed rail was needed or an approval from the Department which posed a potential personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy Rodgers	TELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC9099 (FAS) - (06/04)

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