374603485-9-26-2024-08-AS-SJAB-D9LT9L-20240930143208

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603485
Report Date: 09/25/2024
Date Signed: 09/26/2024 12:02:36 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
08/28/2024 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20240828083955

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:	09/25/2024
		UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Rich Enriquez		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Licensee did not meet client's needs regarding G-Tube.

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 Licensee Rich Enriquez and we discussed the purpose of the visit and elements of the complaint.

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

It was alleged that Licensee was not meeting Client 1's (C1) (an LIC 811 Confidential Names List was provided to the facility representative to identify the client)needs regarding their gastric tube (g-tube). It was reported that possible neglect may be occurring in regards to the maintenance of C1's g-tube, resulting in C1 acting out aggressively in the community. An observation by LPA was conducted on September 5, 2024 to assess the condition of the G-Tube and the client's care. During the observation, the following was noted:The G-Tube area was clean and freshly bandaged. There was no visible sign of infection or improper care at the G-Tube site.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

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-20240828083955

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: 09/25/2024

NARRATIVE
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SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20240828083955

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: 09/25/2024

NARRATIVE

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Incident reports from the facility were reviewed. These reports confirmed that the facility has consistently documented any incidents related to C1, including those concerning the G-Tube. The reports indicated that all incidents were appropriately managed and reported.

LPA interviewed outside agency (OA) who stated that C1 is a non-verbal client that completely stopped eating solid food without any medical explanation. OA stated that a g-tube was placed on C1 due to C1's daily refusal to eat any solid food and C1's eventual weight loss. OA stated that in the recent month C1 has begun to eat solid food again and has slowly gained weight back. OA stated that although C1 has started to eat solid food they are not 100% sure that C1 will continue to eat solid food on a daily basis which is why C1 still has a g-tube. OA stated that C1 is being closely monitored by not only facility staff but also C1's personal physician, nutritionist and behavioral consultant, who are working in conjunction to make sure that when C1's g-tube is removed it is done at the correct time. OA stated they had full confidence in the facility's care. OA reported that they have witnessed firsthand C1's care at the facility and noted adherence to proper procedures.

Interview with Licensee revealed; C1 is being gradually "weaned off" the G-Tube and oral intake of food has been reintroduced as well as oral intake of medication. The licensee anticipates that the G-Tube will be removed in the near future as part of C1's care plan.

The G-Tube area was found to be well maintained and appropriately managed. There is substantial support from an outside agency affirming the quality of care provided by the facility and the various factors surrounding C1's g-tube. The licensee is actively working on transitioning C1 away from the G-Tube and has a clear plan in place for its removal. The facility maintains comprehensive incident reports that reflect consistent and accurate documentation of the client’s condition and any related issues.

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

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

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

LIC9099 (FAS) - (06/04)

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