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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603756
Report Date: 02/16/2023
Date Signed: 02/16/2023 02:29:44 PM

Unsubstantiated


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
05/13/2022 and conducted by Evaluator Esther Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20220513080831
FACILITY NAME:BELLAS FACILITYFACILITY NUMBER:
374603756
ADMINISTRATOR:CASTRO, JONATHANFACILITY TYPE:
735
ADDRESS:2024 HIDDEN MESA ROADTELEPHONE:
(619) 328-2291
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:4CENSUS: 4DATE:
02/16/2023
UNANNOUNCEDTIME BEGAN:
10:14 AM
MET WITH:Hector Guevara, CaregiverTIME COMPLETED:
02:56 PM
ALLEGATION(S):
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Staff did not provide modified diet prescribed by physician.
Food quality did not meet client's nutritional needs.
Staff did not ensure adequate fluid intake for client.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Esther Miller conducted an unannounced complaint investigation visit to the facility in order to deliver findings on the above allegations. LPA was granted entry to the facility by Hector Guevara, Caregiver, after identifying herself and explaining the reason for the visit.

On May 13, 2022, it was alleged that staff did not provide a modified diet prescribed by physician, that food quality did not meet client's nutritional needs, and that staff did not ensure adequate fluid intake for client. Specifically, that this led to Client 1 (C1) becoming hospitalized on February 5, 2022. The Department’s investigation consisted of review of facility records, outside source records, and interviews of facility staff and outside sources.

Facility documents stated that C1 was on a low portion, diabetic diet since admittance. Facility menu showed an alternating schedule of meals that did not have pizza, soda, and hamburgers served frequently.
[Continued on LIC9099-C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Esther Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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 2
Control Number 08-AS-20220513080831
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: BELLAS FACILITY
FACILITY NUMBER: 374603756
VISIT DATE: 02/16/2023
NARRATIVE
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Staff stated that C1 was not on a modified diet and fed a regular diet. Staff also said C1 would only eat pizza on outings, which were not frequent. LIC602 Physician’s Report, signed June 16, 2021, also indicated that C1 was not prescribed to a special diet. Facility records indicated that C1 was not conserved and had the access and choice to eat food not provided by the facility. C1 moved to a different licensed board and care around May 2022. At the new facility, Administrator stated that C1 was on a low carb diet. Administrator also stated C1 ate items that were not in their physician recommended diet when they went out and visited with family, which was frequently. The allegation that staff did not provided a modified diet as prescribed by their physician is found to UNSUBSTANTIATED.

Medical records also indicated that C1 was considered obese with Type 2 diabetes on February 6, 2022. At the time of their hospitalization, C1 was reported to have had a BMI of 30. Facility records indicated that in February 2022, C1 was 4’7” and 137lbs. The Department’s Clinical Consultant reviewed C1’s medical record from their hospitalization on February 5, 2022 and they did not indicate that client was deficient in nutrients. Therefore, the allegation that the food quality at the facility did not meet client’s nutritional needs is found to UNSUBSTANTIATED.

On January 11, 2022, the facility self-reported an incident regarding C1 having a seizure. Facility documents indicated that as a result of the seizure, C1 was prescribed a new medication on January 14, 2022. The facility self-reported to the Department that C1 was sent to the hospital on February 5, 2022 due to C1 having difficulty standing up. Medical records indicated that the medication prescribed had caused C1 to have had increased difficulty ambulating which was the primary reason for the hospitalization. The Department’s Clinical Consultant reviewed the medical records and determined that they not indicate that C1 was dehydrated. Staff also confirmed that C1 drank at least a 16oz bottle water at every meal. Administrator of C1’s current home indicated that C1 enjoys drinking water and does so consistently on their own. The allegation that staff did not ensure sufficient fluid intake is found to be UNSUBSTANTIATED.

Based on the evidence obtained during the complaint investigation, the allegations that staff did not provide a modified diet prescribed by physician, that food quality did not meet client's nutritional needs, and that staff did not ensure adequate fluid intake for client is found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with caregiver; a copy of this report and Licensee's Rights (LIC9058) were provided.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Esther Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2