374603510-2-16-2023-08-AS-JRAE-CPHNME-20230301093458

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603510
Report Date: 02/15/2023
Date Signed: 02/16/2023 10:43:42 AM

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
11/28/2022 and conducted by Evaluator Iby Strong

COMPLAINT CONTROL NUMBER: 08-AS-20221128153448

FACILITY NAME:	AQUINO'S QUALITY HOMECARE NO. 2		FACILITY NUMBER:	374603510
ADMINISTRATOR:	BERNARDO AQUINO		FACILITY TYPE:	735
ADDRESS:	1839 ITHACA STREET		TELEPHONE:	(619) 272-4223
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY:	6	CENSUS: 5	DATE:	02/15/2023
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Caregiver Emma Hernandez Manalo		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee did not obtain medical care for client
Licensee did not assist with transportation to medical appointments
Licensee did not follow client's care plan
Licensee did not made client records available to authorized representative

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to deliver findings in the above complaint allegations. LPA identified herself and discussed the purpose of the visit with Caregiver Emma Hernandez Manalo.

On November 28th, 2022, Community Care Licensing (CCL) received a complaint alleging licensee did not obtain medical care for Client 1 (C1), licensee did not assist C1 with transportation to medical appointments, licensee did not follow C1’s care plan, and licensee did not make C1’s records available to authorized representative.

During investigation, LPA Strong collected pertinent client records as well as facility documentation. Based on C1’s Physician Report dated January 20th, 2022, C1 is diagnosed with Down Syndrome, is bedridden and is unable to communicate; C1 requires assistance with all grooming, medication, bathing, toileting, and management of personal resources.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

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-20221128153448

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: AQUINO'S QUALITY HOMECARE NO. 2	FACILITY NUMBER: 374603510
	VISIT DATE: 02/15/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Continued from LIC9099

Additionally, C1’s Individual Program Plan dated April 27^th, 2022, states C1 is a non-conserved adult, is to received annual dental checkups and receive medical care by primary care physician and nurse consultant. According to allegations received facility is not providing C1 with medical and dental care or transportation to such appointments resulting in C1 having a dental infection and a respiratory infection but no specific date of incident was provided. Based on C1’s records collected, C1 is non-verbal and unable to communicate needs. Interview with administrator revealed C1 attended dental appointments on the following dates, 8/4/2022, 8/5/2022 and 8/19/2022. Interview with administrator also revealed that C1 was routinely examined by a Registered Nurse. Records collected corroborated that C1 was examined by nurse on 9/21/2022, 10/7/2022, 10/25/2022 and on 11/24/2022 the nurse was contacted to provide an urgent consultation. Based on nurse’s assessment on 11/24/2022, emergency personnel were contacted and C1 was admitted to the hospital for Pneumonia. Facility records revealed C1 was diagnosed with Acute Pneumonia on this occasion. Records also showed that C1 was seen at the emergency room on 12/17/2022 for shortness of breathe, then by mobile physician on 1/5/2023 and had a virtual appointment with primary care provider on 2/7/2023. According to interview with outside source, administrator purchased a vehicle specially for the use of transporting C1 to medical appointments. Interview with administrator corroborated that this vehicle is used to take C1 to all their out-of-home appointments, including their dental appointments on 8/4/2022, 8/5/2022 and 8/9/2022.

It was also alleged that C1 was not being taken out of bed or being provided speech services as stated on C1’s care plan. According to records collected, C1 does not have any specified speech services for communication therapy. Records also revealed that mobility training is not appropriate for C1. Records collected indicate that C1 is to be repositioned frequently to prevent skin deterioration and is to be moved from bed to wheelchair on average of two hours per day for socialization purposes. Interview with staff revealed that C1 received specialized medical equipment to facilitate C1’s movement from bed to wheelchair. Interviews with staff revealed that C1 is taken out of bed daily and provided with a change in scenery. Records collected corroborated that C1 is moved out of bed daily for a minimum of two hours. Interview with outside source revealed no prior issues with facility not following Individual Program Plan’s for C1 or any other clients in care.

SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20221128153448

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: AQUINO'S QUALITY HOMECARE NO. 2	FACILITY NUMBER: 374603510
	VISIT DATE: 02/15/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Continued from LIC9099-C

Lastly, it was alleged that responsible party was denied access to C1’s financial records. According to Individual Program Plan dated April 27^th, 2022, C1 does not have an authorized representative. Interview with outside source revealed C1 is not capable to give consent for records to a third party.

Based on LPA's internal interviews, outside source interviews, and record reviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegations are unsubstantiated. An exit interview was conducted with Caregiver Emma Hernandez Manalo, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided

SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3