374603713-9-21-2021-08-AS-JRAE-C7D34C-20210930175456

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603713
Report Date: 09/21/2021
Date Signed: 09/21/2021 05:53:06 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
02/22/2021 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20210222162309

FACILITY NAME:	PARKVIEW MEMORY CARE AT PARADISE VILLAGE		FACILITY NUMBER:	374603713
ADMINISTRATOR:	LAWSON, WILLIAM		FACILITY TYPE:	740
ADDRESS:	735 ARCADIA AVENUE		TELEPHONE:	(619) 475-5040
CITY:	NATIONAL CITY	STATE: CA	ZIP CODE:	91950
CAPACITY:	70	CENSUS: 43	DATE:	09/21/2021
		UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Resident Services Director, Janine Cabrera		TIME COMPLETED:	02:55 PM

ALLEGATION(S):

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Facility staff did not accord resident privacy during toileting

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounce visit to deliver investigative findings. LPA identified herself and discussed the purpose of the visit with Resident Services Director, Janine Cabrera.

Investigation consisted of interviews with staff, outside sources, and residents, review of records, and a tour of the facility. It was alleged that facility staff did not accord resident privacy during toileting. This allegation was based on the claim that facility staff would take R1 to the bathroom with other residents at the same time. Administrator was provided with Confidential Names Form in order to identify R1. Interviews with staff and Administrator consistently reported that taking multiple residents to the bathroom is not a practice being followed.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

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-20210222162309

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: PARKVIEW MEMORY CARE AT PARADISE VILLAGE	FACILITY NUMBER: 374603713
	VISIT DATE: 09/21/2021

NARRATIVE

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Staff reported that they take residents to the bathroom in common areas individually every two (2) hours or more often as needed to meet residents’ needs. In addition, for residents that are not as independent and need more incontinence care they are taken to their rooms to be cleaned up and refreshed as needed. Interviews with outside sources consistently reported that they had no problems with the care being provided at the facility and that R1 did not voice any issues with incontinence care and privacy. LPA attempted to interview residents; however, due to their cognitive abilities they were not able to provide any relevant information.

The Department has investigated the above-mentioned allegation and has found that based upon interviews, record review, and observations, there is insufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Therefore, this allegation is deemed unsubstantiated.

An exit interview was conducted with Resident Services Director, Janine Cabrera and a copy of this report, along with Licensee Rights (LIC 9058 01/16), were provided to the Administrator Aguilar and Resident Services Director, Cabrera via electronic mail. An electronic receipt of confirmation was requested to be sent by the Administrator upon receipt of the documents.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

LIC9099 (FAS) - (06/04)

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