374603587-9-26-2024-08-AS-JLOT-D9HRQR-20240927131354

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603587
Report Date: 09/25/2024
Date Signed: 09/26/2024 07:10:06 AM

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
09/14/2023 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20230914084557

FACILITY NAME:	CHANCELLOR HOME		FACILITY NUMBER:	374603587
ADMINISTRATOR:	ASTRID GARCIA		FACILITY TYPE:	735
ADDRESS:	13904 CHANCELLOR WAY		TELEPHONE:	(858) 842-4534
CITY:	POWAY	STATE: CA	ZIP CODE:	92064
CAPACITY:	4	CENSUS: 3	DATE:	09/25/2024
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Associate Administrator Cheryl Agnon		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff coached a client on what to say to regional center staff.
Facility did not ensure that resident attended scheduled medical appointments.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to conclude a complaint investigation regarding the above-mentioned allegations. LPA Correia met with Associate Administrator Cheryl Agnon, identified herself, and explained the purpose of the visit.

The Department’s investigation consisted of facility and client record reviews, and staff and client interviews.

It was alleged that facility staff coached Client 1 (C1) on what to say to Outside Agency 1 (OSA1) to portray the facility had offered more events/activities than the facility did. During the interview C1 retracted their statement about activities offered at the facility and disclosed staff had often tried to encourage them to participate in activities but they would decline. A client records review revealed C1 had become unmotivated and was not engaging in social events/activities. In addition, a facility records review revealed the facility held Client Counsel Meetings for the clients to express to staff the activities and outings they wanted to schedule.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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-20230914084557

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: CHANCELLOR HOME	FACILITY NUMBER: 374603587
	VISIT DATE: 09/25/2024

NARRATIVE

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It was also alleged that facility staff did not ensure that C1 attended a medical appointment on September 14, 2023. An interview with Staff 1 (S1), Staff 2 (S2), and Staff 3 (S3) all revealed C1 notified staff the same day of the medical appointment and that the office was 45 minutes away. The interviews with S1 and S2 also revealed that clients need to provide advance notice to ensure availability. An interview conducted with C1 corroborated they asked for transportation on the same day of their appointment. In addition, a facility records review corroborated C1 was not scheduled for the appointment per the facility transportation schedule.

Based on interviews and records reviews, the above-mentioned allegations were determined to be unsubstantiated, an unsubstantiated finding means 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 with Associate Administrator Agnon and a copy of this report and Licensee Rights (LIC 9058) will be provided for facility records.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

LIC9099 (FAS) - (06/04)

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