374603513-2-7-2024-08-AS-LTEZ-D3TU2L-20240329151208

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603513
Report Date: 02/07/2024
Date Signed: 02/07/2024 12:50:21 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
11/30/2023 and conducted by Evaluator Renita Hall

COMPLAINT CONTROL NUMBER: 08-AS-20231130163001

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: 8	DATE:	02/07/2024
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Art Vinarao, Caregiver		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

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Staff neglect resulting in hospitalization
Staff did not meet resident's needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to deliver findings regarding the allegations mentioned above LPA was allowed entry by Art Vinarao, Caregiver. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Caregiver.

The Department investigated the above-listed complaint allegations. The investigation consisted of a tour of the facility, interviews with staff and outside sources, and a records review.

On November 30, 2023, the Department received a complaint alleging that Staff neglect resulted in hospitalization and Staff not meeting the resident's needs. The records reviewed indicated that the resident was referred to the facility by the hospital for comfort and care on November 27, 2023. No admission agreement was signed by the Power of Attorney (POA) for the resident nor was a Hospice agreement signed.

Continued on 9099 C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) -76-2317
LICENSING EVALUATOR NAME: Renita Hall	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024

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-20231130163001

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: PARKWAY GARDENS RETIREMENT CARE HOME	FACILITY NUMBER: 374603513
	VISIT DATE: 02/07/2024

NARRATIVE

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The Administrator, Carminida Ramirez stated that she had spoken to the POA several times to come and sign the admission agreement with no response. Hospice also stated that on the date the resident was taken to the hospital, the POA denied assistance.

Based on the investigation findings, it can be concluded that the allegations of staff neglect resulting in hospitalization and staff not meeting the resident's needs are unsubstantiated. A finding that is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted and a copy of this report along with the Licensee Rights (LIC 9058) was provided to Art Vinarao, Caregiver. His signature on this form confirms receipt of the documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) -76-2317
LICENSING EVALUATOR NAME: Renita Hall	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024

LIC9099 (FAS) - (06/04)

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