374603513-5-31-2022-08-AS-LTEZ-CEZ2QR-20220601173621

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603513
Report Date: 05/26/2022
Date Signed: 05/31/2022 09:09:11 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
03/22/2022 and conducted by Evaluator Dawn Segura

COMPLAINT CONTROL NUMBER: 08-AS-20220322163331

FACILITY NAME:	PARKWAY GARDENS RETIREMENT CARE HOME		FACILITY NUMBER:	374603513
ADMINISTRATOR:	CARMINDA RAMIREZ		FACILITY TYPE:	740
ADDRESS:	660 VAN HOUTEN AVE		TELEPHONE:	(619) 444-2729
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY:	15	CENSUS: 12	DATE:	05/26/2022
		UNANNOUNCED	TIME BEGAN:	11:11 AM
MET WITH:	Carminda Ramirez, Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Resident was illegally evicted.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver findings from the investigation conducted into the above listed complaint allegation. LPA was granted entry into the facility by Arthuro Vinarao, Staff, to whom she disclosed the reason for the visit. The administrator, Carminda Ramirez, was contacted by phone, informed of the reason for the visit, and arrived a short time later.

Community Care Licensing (CCL) has investigated the above listed allegation. The investigation consisted of a tour of the facility, review of records, and interviews of administrator, Resident 1 (R1) [Administrator was provided an LIC 811 Confidential Names List that identifies the resident], and outside sources.

It was alleged that R1 was transported to a local hospital a few days after moving into the facility, and the facility refused to accept the resident back into the facility due to non-payment of facility fees.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

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

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220322163331

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: PARKWAY GARDENS RETIREMENT CARE HOME	FACILITY NUMBER: 374603513
	VISIT DATE: 05/26/2022

NARRATIVE

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Based upon information obtained during the course of the investigation, R1 was accepted and moved from a local hospital into the facility on 3/13/2022. On several dates thereafter, R1 called and requested emergency ambulance service to be transported to the hospital due to extreme chronic pain. According to information obtained, R1 was transported to the hospital on 3/18/2022, and on or about 3/20/2022, hospital personnel notified Staff 1 (S1) that R1 was ready to be discharged back to the facility. S1 informed hospital personnel that R1 did not want to be at the facility and requested the assistance of hospital staff with getting R1 to understand that residing in the facility required execution of an admission agreement and payment of a monthly fee, both of which R1 was not willing to do.

Interviews conducted during the investigation yielded that R1 expressly did not want to reside in the facility because it was not a medical facility, and the facility staff were not able to provide medical attention, which is what R1 was seeking and desired to have. Further, prior to moving into the facility, R1 was not aware that the facility staff were not able to, nor would the staff be providing onsite medical care. Between 3/20/2022 and 3/23/2022, R1 continued to remain in the hospital while S1 made attempts to come to an agreement with R1. During that time, an outside source assisted with efforts to get R1 to agree to return and to agree to the terms associated with residing in the facility. R1 returned to the facility on or about 3/23/2022, agreed to sign an admission agreement on 3/30/2022, and remained in the facility until the time of death in May of 2022.

Although R1 remained in the hospital three days after the hospital notified facility staff that R1 was ready for discharge, the investigation did not reveal information to conclude that S1 or any other staff of the facility refused R1’s return to the facility. Based upon the foregoing the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Carminda Ramirez, Administrator and a copy of this report and Licensee Rights (LIC 9058) were provided to the administrator at the conclusion of the visit. Her signature on this form acknowledges receipt of the rights and a copy of this report.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

LIC9099 (FAS) - (06/04)

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