374603664-8-1-2021-08-AS-DPOL-C6ES5V-20210831133457

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603664
Report Date: 04/26/2021
Date Signed: 08/01/2021 12:31:59 PM

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
08/07/2020 and conducted by Evaluator Evangelica Torres

COMPLAINT CONTROL NUMBER: 08-AS-20200807164154

FACILITY NAME:	VISTA DEL LAGO MEMORY CARE		FACILITY NUMBER:	374603664
ADMINISTRATOR:	JEFF GONZALEZ		FACILITY TYPE:	740
ADDRESS:	1817 AVENIDA DEL DIABLO		TELEPHONE:	(760) 741-2888
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92029
CAPACITY:	0	CENSUS: 83	DATE:	04/26/2021
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Administrator, Jeff Gonzalez.		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Licensee unlawfully solicited resident #1 with an additional fee to be approved for MediCal benefits.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Eva Torres conducted virtual visit to deliver the findings on the above allegation due to COVID-19. LPA identified herself and disclosed the purpose of the phone with Administrator Jeff Gonzalez. The investigation included a review of records and interviews.

It was alleged that the licensee unlawfully solicited Resident #1 (See LIC 811- Confidential Names List for R1) with an additional fee to be approved for MediCal Benefits.

The investigation revealed that the facility accepts private pay residents and various types of insurance to assist with the care cost. In randomly reviewing resident's records, including but limited to their admission agreements, physician's reports, assessments, and care plans, it showed that the admission agreement list multiple services in meeting the resident's care and supervision needs for a fee. The resident's physician reports, assessments, and care plans assisted the licensee in identifying the cost to meet the resident's needs.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2021

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-20200807164154

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: VISTA DEL LAGO MEMORY CARE	FACILITY NUMBER: 374603664
	VISIT DATE: 04/26/2021

NARRATIVE

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Though the admission agreement did not list the independent service fee to assist families in applying for MediCal and insurance supplement programs, staff interviews were consistent in describing that the service was separate from the care services provided by the licensee. Staff interviews also confirmed that the service is meant to assist families in maintaining their loved ones in a licensed facility at an affordable cost. It was further explained that in seeking approval to obtain MediCal and its supplement insurance benefits was at times lengthy, as the acceptance timeline depended on a separate process beyond the licensee's control. Staff interviews also noted that they explain the independent service and the approval process for MediCal benefits during the resident's admission at the facility to give families comfort in knowing there are options in assisting with care costs. In addition, staff interviews also revealed that the independent service is voluntary and informational; therefore, allowing the residents and their responsible parties to choose whether to accept their assistance or seek support from a private company to help them apply for MediCal and its insurance supplement programs.

LPA interviewed many responsible parties, and their interviews did not produce evidence that the licensee misled them in paying an independent fee to obtain approval for MediCal benefits. Furthermore, their interviews were also consistent in describing that the independent service to help residents with care cost was an option and separate from the admission agreement under basic care services provided by the licensee. LPA attempted to interview a random sampling of residents. However, their interviews were unable to be obtained due to the severity of their cognitive impairment and COVID-related concerns.

Based on conducted interviews and a review of documents, there is insufficient evidence to prove or disprove that the allegation occurred; therefore, the complaint investigation findings are determined to be unsubstantiated. LPA conducted an exit interview was with Administrator Gonzalez. The Licensee's Rights (LIC9058 01/16), along with a copy of this report, was emailed to Mr. Gonzalez. A reply email or return receipt from Mr. Gonzalez will confirm receipt of documents. This is amended version of the original report created on 04/26/21.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2021

LIC9099 (FAS) - (06/04)

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