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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604057
Report Date: 10/26/2023
Date Signed: 10/26/2023 08:37:00 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
05/10/2023 and conducted by Evaluator Renita Hall
COMPLAINT CONTROL NUMBER: 08-AS-20230510100620
FACILITY NAME:PLATEAU VILLAGE MEMORY CAREFACILITY NUMBER:
374604057
ADMINISTRATOR:AYERSMAN, JENNIEFACILITY TYPE:
740
ADDRESS:4960 MILLS STREETTELEPHONE:
(619) 644-1100
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:0CENSUS: DATE:
10/26/2023
UNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:TIME COMPLETED:
10:33 AM
ALLEGATION(S):
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Facility is unsanitary
INVESTIGATION FINDINGS:
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On May 18, 2023 an investigation was conducted regarding the sanitation conditions at Plateau Village Memory Care. The purpose of this investigation was to assess the validity of the claim that the facility is unsanitary. The investigation aimed to determine the current state of the facility's cleanliness and whether any remedial actions were being taken.

Plateau Village Memory care recently underwent a change in ownership. The new management has initiated various improvements, including the replacement of the old carpet throughout the facility. The specific complaint received alleged the staff do not clean after a resident urinates, suggesting unsanitary conditions.

The overall cleanliness of the facility was found to be satisfactory. The majority of the areas were well-maintained, with no visible signs of unsanitary conditions. The cleaning staff was observed performing their duties diligently.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (619) -76-2317
LICENSING EVALUATOR NAME: Renita HallTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
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-20230510100620
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: PLATEAU VILLAGE MEMORY CARE
FACILITY NUMBER: 374604057
VISIT DATE: 10/26/2023
NARRATIVE
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The cleaning staff was able to explain procedures for cleaning after a resident has an incontinence accident.

While a faint urine smell was detected in some areas with old carpeting, it was important to note that the facility was in the process of replacing the old carpet throughout the entire facility. The new ownership had already taken steps to address this issue, indicating their commitment to improving the facility's sanitation. The facility management had recognized the need for carpet replacement and had already initiated the process. This demonstrated their proactive approach to addressing the reported unsanitary conditions. The Department was informed that the replacement of the old carpet would be completed within the next three to four months.

Based on the investigation, it can be concluded that the claim of the facility being unsanitary is un-substantiated. While a faint urine smell was detected on the old carpet, the facility management had already taken appropriate measures by replacing the carpet throughout the facility. The new ownership's commitment to improving the facility's sanitation was evident.

A copy of this report and Licensee's Rights (LIC 9058 03/22) were mailed to the last known address for the facility.
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (619) -76-2317
LICENSING EVALUATOR NAME: Renita HallTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC9099 (FAS) - (06/04)
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