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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603520
Report Date: 01/27/2023
Date Signed: 01/27/2023 02:41:55 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
01/18/2023 and conducted by Evaluator Marisela Garcia-Centeno
COMPLAINT CONTROL NUMBER: 08-AS-20230118111435
FACILITY NAME:VIBRANT LIVINGFACILITY NUMBER:
374603520
ADMINISTRATOR:NORRIS, JULIEFACILITY TYPE:
740
ADDRESS:5723 BOUNTY STREETTELEPHONE:
(619) 269-6915
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:6CENSUS: 5DATE:
01/27/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Caregiver, Alma MaldonadoTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Unlawful Eviction
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 Caregiver, Alma Maldonado, to whom she identified herself. Administrator, Julie Norris called the facility and LPA siscussed the purpose of the visit.

The Department investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, multiple interviews with staff, and records review, including resident and facility records and other relevant evidence pertinent to this investigation.

On January 18, 2023, Community Care Licensing (CCL) received a complaint alleging that licensee issued an unlawful eviction notice to Resident (R1), [an LIC 811 Confidential Names List was provided to licensee to identify the Resident] for violating house rules. On January 20, 2023 during a tour of the facility, a health and safety check was conducted, and R1 was observed present at the facility.
(continue at LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-CentenoTELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
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-20230118111435
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: VIBRANT LIVING
FACILITY NUMBER: 374603520
VISIT DATE: 01/27/2023
NARRATIVE
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(Continue from LIC9099)

Record review showed the specific house rules were included in the Admissions Agreement signed and dated on May 14, 2022 by R1’s responsible party/power of attorney. However, review of the initial 30-day eviction notice presented to R1 on January 11, 2022 was determined to be an unlawful eviction. The notice did not include facts and details, such as date, place, witnesses, and circumstances concerning the reason for the eviction, which is a requirement of eviction procedures per Title 22 regulations. During the course of the investigation, licensee issued a revised 30-day eviction notice with the added details required, as well as a nonpayment clause. R1 was not able to pay the rate for basic services within ten days of the January 21, 2023 due date. The effective date of eviction was revised to February 21, 2023. Licensee included in the eviction notice available resources to assist in identifying alternative housing and care options for the R1. Based on review of records, this revised eviction notice was determined to be a lawful eviction notice.

Although, a revised eviction notice was subsequently issued, the Department has found that there was sufficient evidence to corroborate the above allegation since it involved the initial notice. Therefore, this allegation is deemed to be substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met. A deficiency was cited per Title 22, Division 6, Chapter 8 of the California Code of Regulations and are listed on LIC 9099-D. A plan of correction was developed with Administrator, Julie Norris.

This report was discussed with Administrator, Julie Norris via telephone and with Caregiver, Maldonado, to whom a copy of this report along with Licensee Rights (01/2016) was provided at the conclusion of the visit.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-CentenoTELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20230118111435
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: VIBRANT LIVING
FACILITY NUMBER: 374603520
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/27/2023
Section Cited
CCR
87224(d)
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 Eviction Procedures
87224(d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. This requirement was not met as evidenced by:
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Licensee issued a lawful eviction 30-Day notice to R1 on 1/21/2023. Plan of Correction was completed on 1/21/2023.
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Based on records review and staff interviews, licensee did not issue a lawful eviction notice to R1. This posed a potential personal rights risk to 1 of 5 residents 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: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-CentenoTELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3