374604019-8-22-2022-08-AS-SJAB-CHTKV4-20220831081343

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604019
Report Date: 08/22/2022
Date Signed: 08/22/2022 03:53:12 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
10/19/2020 and conducted by Evaluator Daniel Pena

COMPLAINT CONTROL NUMBER: 08-AS-20201019095138

FACILITY NAME:	POINT LOMA ELDER CARE		FACILITY NUMBER:	374604019
ADMINISTRATOR:	GAURAV RATHI		FACILITY TYPE:	740
ADDRESS:	3941 LIGGET DRIVE		TELEPHONE:	(619) 255-6448
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92106
CAPACITY:	6	CENSUS: 6	DATE:	08/22/2022
		UNANNOUNCED	TIME BEGAN:	02:42 PM
MET WITH:	Joseph Buda, Caregiver		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff failed to follow admission agreement

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced complaint visit to deliver investigative findings regarding the above allegation. LPA identified himself and was invited into the facility. LPA met with Joseph Buda, Caregiver and discussed the purpose of today's visit.

This complaint alleges the licensee failed to follow the admission agreement and increased rent for the care of Resident 1 (R1) (See LIC 811 for a list of confidential names).

During the course of the investigation, LPA collected records, conducted interviews and toured the facility.
Records showed that R1’s basic rate at admission (9/12/19) and at the time this complaint was filed (10/19/20) was $5750.00 per month.

On 10/01/2020, records confirm that R1 was reappraised by a physician. The records indicate that R1 required additional assistance with Activities of Daily Living than what was previously required at admission. The licensee advised R1’s responsible party that due to a change in R1’s condition, a higher

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

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-20201019095138

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: POINT LOMA ELDER CARE	FACILITY NUMBER: 374604019
	VISIT DATE: 08/22/2022

NARRATIVE

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level of care was now required. Interviews and records showed that the responsible party protested the charges and they were never increased. The licensee stated that R1’s condition required more one on one care. Licensee states the facility increased R1’s care but did not increase their rent at the request of R1's responsible party.

Facility invoices showed that R1's rent was not increased until more than one year after this complaint was filed. Records prove that in August 2021, the licensee sent R1’s responsible party an email informing them that R1's rent would be increased from $5,750 to $6,250 due to “costs of labor, liability insurance, rents, workers compensation, among others, and also deterioration of R1’s condition.” Records and interviews confirm that an increase in R1’s rent was not actually applied until October 1, 2021.

The admission agreement states that “We shall provide the resident or the representative a written notice of a rate increase that is due to a change in the level of care within 2 business days after the change in the level of care.”

Records and interviews revealed that the facility provided the responsible party the required time and written notice of the rent increase. Additionally, the licensee provided physician reappraisals that described the changes in R1’s condition which required a higher level of care.

Based on interviews and record review, the Department’s investigation has determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred and is therefore determined to be unsubstantiated.

This report was discussed with Mr. Buda, Caregiver and a copy of this report and the Licensee Rights (01/2016) was given to Mr. Buda at the conclusion of the visit.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel Pena	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

LIC9099 (FAS) - (06/04)

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