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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603513
Report Date: 08/01/2023
Date Signed: 08/01/2023 01:57:00 PM

Substantiated


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
07/27/2023 and conducted by Evaluator Dawn Segura
COMPLAINT CONTROL NUMBER: 08-AS-20230727102050
FACILITY NAME:PARKWAY GARDENS RETIREMENT CARE HOMEFACILITY NUMBER:
374603513
ADMINISTRATOR:CARMINDA RAMIREZFACILITY TYPE:
740
ADDRESS:660 VAN HOUTEN AVETELEPHONE:
(619) 444-2729
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:15CENSUS: 8DATE:
08/01/2023
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Carminda Ramirez via telephoneTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Unlawful eviction.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to conduct an investigation into the above listed complaint allegation. LPA introduced herself and was granted entry into the facility by Arthuro Vinarao, Staff. The administrator, Carminda Ramirez, was contacted via telephone, and LPA disclosed the reason for the visit to the administrator.

Community Care Licensing (CCL) has investigated the above listed allegation. The investigation consisted of a tour of the facility, review of records, and interview of facility staff.

It was alleged that Resident 1 (R1) [Administrator was provided an LIC 811 Confidential Names List that identifies the resident] was issued eviction notices for smoking while oxygen was in use, refusing care from facility staff, and being noncompliant. It was reported that R1 was initially given a notice with 3 days to move out of the facility, and, a week later, R1 was given a notice with 30 days to move.

Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn SeguraTELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
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-20230727102050
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: 08/01/2023
NARRATIVE
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Records reviewed and interview conducted revealed that R1 was issued a 3-day notice on May 25, 2023, as an incentive to see his/her doctor, and was issued a 60-day notice to vacate on June 1, 2023. Once R1 agreed to visit the doctor and scheduled an appointment, the 3-day notice was rescinded by the facility’s licensee on July 27, 2023. Community Care Licensing did not approve issuance of a 3-day notice to quit to R1.

Based upon the foregoing, the above allegation is substantiated. This finding means that the preponderance of the evidence standard has been met and the allegation is valid. Deficiency is cited in accordance with California Code of Regulations, Title 22, Division 6, Chapter 8 and noted on the attached LIC 9099-D.

An exit interview was conducted with Carminda Ramirez, via telephone, and a copy of this report and Licensee/Appeal Rights (LIC 9058) were provided to Hailee Bazua, House Manager, at the conclusion of the visit. Her signature on this report confirms receipt.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn SeguraTELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20230727102050
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/22/2023
Section Cited
CCR
87224(b)
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Eviction Procedures. The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident upon three (3) days written notice to quit.
This requirement was not met as evidenced by:
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Administrator agreed to ensure that licensee and administrator receive outside vendor training on proper eviction procedures in accordance with Title 22 regulations. Administrator agreed to provide proof of training to Community Care Licensing by the POC due date.
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Licensee did not obtain written approval from Community Care Licensing prior ot issuing a 3-day notice to quit to R1, 1 of 8 residents in care. This posed a potential personal rights violation to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn SeguraTELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3