374603485-4-26-2024-08-AS-SJAB-D4TPZE-20240430114524

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603485
Report Date: 04/26/2024
Date Signed: 04/26/2024 12:10:27 PM

Unsubstantiated

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
04/03/2024 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20240403130718

FACILITY NAME:	VILLA SAN FRANCISCO		FACILITY NUMBER:	374603485
ADMINISTRATOR:	ELIZABETH ENRIQUEZ		FACILITY TYPE:	735
ADDRESS:	734 RIVERLAWN AVE		TELEPHONE:	(619) 500-5356
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	4	CENSUS: 4	DATE:	04/26/2024
		UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Liz Enriquez		TIME COMPLETED:	12:16 PM

ALLEGATION(S):

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Staff were not properly trained to administer client's medications.
Staff did not administer client's medications as prescribed.
Client sustained an unexplained injury while in care.
Staff did not properly dispose client's soiled clothing.
Staff did not ensure facility is free of pests.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver findings on the above allegation. LPA met with Administrator Liz Enriquez and we discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegations. The investigation consisted of LPA observation, records review and interviews with facility staff and outside sources.

It was reported to CCL that staff were not properly trained to administer client's Medications. Review of staff training records indicated that all staff members responsible for medication administration had completed the required training and certifications. Interview with outside agency (OA) revealed that facility staff had received adequate training. OA further stated that facility staff were actually "over trained" meaning they have exceeded the required amount of training that OA required.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

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 3

Control Number 08-AS-20240403130718

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: VILLA SAN FRANCISCO	FACILITY NUMBER: 374603485
	VISIT DATE: 04/26/2024

NARRATIVE

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It was alleged that staff did not administer client's medications as prescribed. Medication logs were reviewed for the month of February and March 2024, and it was found that medications were administered as prescribed to clients during the reported period. No instances of medication errors or omissions were documented in the medication logs or incident reports.

It was alleged that client sustained an unexplained injury. Records review revealed that it was promptly reported and addressed by staff members. CCL received an incident report regarding the injury on October 2, 2023.

It was alleged that facility staff did properly dispose of client's soiled clothing. LPA toured the facility on April 4, 2024 and found no soiled clothes in any area of the facility. LPA did observe each client had their own plastic clothes hamper that is used to place all soiled clothes. Facility protocols for handling and disposing of soiled clothing were reviewed and found to be in line with industry standards. No evidence was found to suggest improper disposal of client's soiled clothing during the reported period.

It was alleged that staff did not ensure that facility was free of pests. LPA toured the facility on April 4, 2024 and did not observe any pests including spiders and cockroaches in any room in the facility including the garage. Pest control records were reviewed, and it was found that the facility had a regular pest control schedule in place. Interviews with staff members and residents did not reveal any ongoing pest issues within the facility.

Interview with outside agency (OA) revealed OA visits the facility at a minimum of every three months. OA stated that they have personally watched staff disperse medication, and have reviewed all facility documents and training records. OA stated that they have spoken to facility staff privately and none of the staff have ever approached OA with any of the allegations listed on this complaint. OA further stated that they have seen the clients outside of the facility and they are always well dressed, properly groomed and most importantly happy.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20240403130718

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: VILLA SAN FRANCISCO	FACILITY NUMBER: 374603485
	VISIT DATE: 04/26/2024

NARRATIVE

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Statement from Administrator revealed that once the staff begin working at the facility, staff are provided with an on site orientation by the Administrator. The orientation includes; purpose of program, services provided, staff duties and schedule, client service plans, client rights, medication administration, health and safety, Special Incident Reports and client abuse reporting. Staff also receive numerous hours of ongoing training to support all clients in care.

Based upon the foregoing, the above listed allegations are unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegations are not valid.

An exit interview was conducted with Liz Enriquez. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Liz Enriquez whose signature below verifies receipt of these rights.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

LIC9099 (FAS) - (06/04)

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