374603565-12-20-2023-08-AS-IESA-CYYNC3-20231229092002

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603565
Report Date: 12/20/2023
Date Signed: 12/20/2023 03:05:45 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
01/12/2022 and conducted by Evaluator Becky Kennedy

COMPLAINT CONTROL NUMBER: 08-AS-20220112123226

FACILITY NAME:	LA VIDA REAL		FACILITY NUMBER:	374603565
ADMINISTRATOR:	KIMBERLY GARCIA		FACILITY TYPE:	740
ADDRESS:	11588 VIA RANCHO SAN DIEGO		TELEPHONE:	(619) 660-5778
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92019
CAPACITY:	177	CENSUS:	DATE:	12/20/2023
		UNANNOUNCED	TIME BEGAN:	02:43 PM
MET WITH:			TIME COMPLETED:	03:35 PM

ALLEGATION(S):

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Physicial abuse Resident sustained an unexplained fracture while in care.
Resident's call button is not accessable.

INVESTIGATION FINDINGS:

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Licensing Program Analyst Becky Kennedy concluded the investigation which began on 3/16/2021. LPA Kennedy made an unannounced visit to the above facility today and was greeted by Administrator, David Armour. LPA advised licensee of the reason for today's visit and delivered the investigation findings on the above allegations.

Investigation consisted of observations, interviews with residents, staff, outside sources, records reviews, and tour of the interior and exterior facility. It was alleged that Resident 1 (R1) sustained a fracture on their hand as a result of physical abuse.

Investigation revealed that R1 has both physical and mental health diagnoses including being blind, and with difficulty hearing.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Icela Estrada
LICENSING EVALUATOR NAME: Becky Kennedy
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

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-20220112123226

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: LA VIDA REAL	FACILITY NUMBER: 374603565
	VISIT DATE: 12/20/2023

NARRATIVE

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Or about January 8th, 2022, Witness 1 (W1) noted that there was an injury to R1’s left index finger. R1 reported to W1 that they ran their wheelchair into a wall crushing their finger. W1 asked Staff Member 1 (S1) to check R1’s hand. S1, who is a Licensed Vocational Nurse, recalled noticing some light bruising on R1’s hand about 5:00 PM. S1 moved the hand lightly and R1 did not report any pain. S1 did not document their assessment or elevate any concerns regarding R1. S1 reported that R1 slept through to 11:00PM, the end of S1’s shift, without complaint of pain, even when receiving care.

On or about January 9th, 2022, W1 noticed an injury to R1’s right hand.

On January 10th Staff Member 2 (S2) was getting R1 up for breakfast and noticed the bruising on R1’s hands and R1 was complaining of pain. Witness 2 (W2) came to the room already aware that R1 had injured hands. W2 transported R1 to the hospital about 10:30 AM. At about 5:30 PM R1 returned to the facility with a soft cast and a diagnosis of a metacarpal fracture to the right ring finger.

The physician that treated R1’s hand injuries did not report any suspicion of physical abuse.
During the course of the investigation, it was revealed that R1 reported multiple and incompatible explanations for their injured hands.

The investigation included interviews with staff members who provide care for R1 and all report training and practices that would protect R1 from injuries, specifically to R1’s hands.
It is unclear how R1 sustained the injuries.

It was further alleged that the call button was not assessable to R1.
Based on observation and interviews, there are always three call buttons in R1’s room. One in the bathroom, one in the living room and a portable call button in a box, generally kept on a table. R1 became agitated when the box with the call button was moved to a location, thought to be more accessible to R1. The call button was returned to the table per R1’s preference.

There is insufficient evidence to conclude that R1 did not have access to a call button.
Based on inconsistent statements, and the lack of evidence or witnesses to corroborate or support the allegations, the findings are unsubstantiated. An exit interview was conducted and a copy of this report, and appeal rights were given to Administrator, David Armour.

SUPERVISORS NAME: Icela Estrada
LICENSING EVALUATOR NAME: Becky Kennedy
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

LIC9099 (FAS) - (06/04)

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