374603509-9-29-2022-08-AS-DPOL-CJRS6S-20220930133624

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603509
Report Date: 09/29/2022
Date Signed: 09/29/2022 04:35:31 PM

Unsubstantiated

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
07/27/2022 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20220727145551

FACILITY NAME:	WESTMONT AT SAN MIGUEL RANCH		FACILITY NUMBER:	374603509
ADMINISTRATOR:	NEWTON, RANDAL		FACILITY TYPE:	740
ADDRESS:	2325 PROCTOR VALLEY RD		TELEPHONE:	(619) 271-4385
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91914
CAPACITY:	105	CENSUS: 80	DATE:	09/29/2022
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Resident Services Director, Dominick Orana		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility did not treat bedbug infestation

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to deliver investigative findings. LPA was greeted by, identified herself to, and discussed the purpose of the visit with Resident Director (RSD), Domenick Orana and Executive Director, William Byrne, III.

The Department investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, multiple interviews with staff and outside sources, and records review, including medical records and other relevant evidence pertinent to this investigation such as Pest Control maintenance contract agreements and Inspection Reports.

On July 27, 2022, Community Care Licensing (CCL) received a complaint alleging that facility staff did not treat a bed bug infestation. It was alleged that on July 24, 2022, a dead bed bug was found on Resident (R1's) bed, [an LIC 811 Confidential Names List was provided to staff to identify the Resident].

(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

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-20220727145551

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: WESTMONT AT SAN MIGUEL RANCH	FACILITY NUMBER: 374603509
	VISIT DATE: 09/29/2022

NARRATIVE

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(Continue from LIC9099)
It was further alleged that since June 23, 2022, R1 had visible skin irritations and had been experiencing itching from what appeared to be bed bug bites. It was alleged that despite multiple reports to facility management regarding the situation, no actions had been taken by the facility to treat the infestation.

On August 4, 2022, the Department conducted a tour of the facility that included a full inspection of six residents’ rooms, which revealed no signs of a bed bugs. During the inspection of the rooms, it was observed the bed mattresses were clean and had clean mattress covers and bed sheets, in good condition. The fabric-covered chairs located next to the beds in each of the rooms were inspected as well. There was no observable evidence of bed bugs in the rooms inspected on August 4, 2022.

In addition, records reviews confirmed that the facility had an active contract agreement with a certified pest control company since November 18, 2014. Review of the terms of the pest control contract indicated that facility inspections were performed every 30 days and treatments were applied when required. Per staff interviews two separate inspections were conducted by two different certified pest control companies on July 26, 2022 and August 1, 2022, of three rooms, R1's room and the two adjacent rooms next R1's room. A third inspection was also conducted of R1's room on September 14, 2022. Review of the inspection reports indicated no findings for bed bugs and no treatments were necessary. Per interviews with outside sources, it was confirmed that there had not been any pest infestations other than occasional ant problems which were treated accordingly.

Staff interviews with direct care staff were inconsistent; however, the majority of staff indicated that they had not observed bed bugs in the residents’ rooms and they also reported that residents had not expressed concerns regarding bed bug bites

Interviews with outside sources consistently indicated they had never observed a bed bug and did not report any issues with bed bugs. Interviews with facility staff revealed that when the bed bug claim was reported they took immediate action. Facility staff identified six (6) residents that were having symptoms of itchy skin, immediate medical attention was provided, two (2) residents were diagnosed and treated for scabies. The other four (4) residents including R1 skin irritations were treated for dry skin and possible eczema. Review of residents’ medical records confirmed the information provided. The rooms were deep cleaned, two mattresses for hospice residents were replaced and linens were thoroughly washed and sanitized.
(Continue LIC9099C

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220727145551

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: WESTMONT AT SAN MIGUEL RANCH	FACILITY NUMBER: 374603509
	VISIT DATE: 09/29/2022

NARRATIVE

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Based on observations, interviews with key staff and outside sources, and review of pertinent pest control inspection reports, there was insufficient evidence found to support the allegation that facility staff did not treat bed bug infestation. Due to a lack of evidence, the allegation is deemed to be unsubstantiated. A finding that is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence that the alleged violation occurred.

An exit interview was conducted with RSD, Orana to whom a copy of this report, LIC 811 and Licensee Appeal Rights (9058 01/16) were provided at the conclusion of the visit.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022

LIC9099 (FAS) - (06/04)

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