374604060-4-24-2023-08-AS-DPOL-CYQVH3-20231221152628

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604060
Report Date: 04/24/2023
Date Signed: 04/24/2023 06:37:05 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
03/14/2022 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20220314143122

FACILITY NAME:	GROSSMONT GARDENS SENIOR LIVING		FACILITY NUMBER:	374604060
ADMINISTRATOR:	LANE HERMOSILLO		FACILITY TYPE:	740
ADDRESS:	5480 MARENGO AVE		TELEPHONE:	(619) 463-0281
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	425	CENSUS: 205	DATE:	04/24/2023
		UNANNOUNCED	TIME BEGAN:	06:20 PM
MET WITH:	Executive Director Reggie Jones		TIME COMPLETED:	06:45 PM

ALLEGATION(S):

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Facility staff took resident’s personal property.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced subsequent visit to deliver a finding regarding the above prior complaint allegation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Executive Director Reggie Jones.

It was alleged that during March 2022, facility staff took Resident #1 (R1)’s personal property. (The specific items alleged taken from R1’s bedroom were: one (1) hearing aid, one (1) electric razor, eight (8) pieces of costume jewelry, and one spiral bound notebook.) CCLD’s investigation involved interview of R1 and relevant staff and outside sources. Pertinent care, medical, and administrative records were also reviewed.

R1 themselves told LPA that they often hid their belongings, and that they sometimes forgot where they hid them.

[CONTINUED ON LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

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-20220314143122

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: GROSSMONT GARDENS SENIOR LIVING	FACILITY NUMBER: 374604060
	VISIT DATE: 04/24/2023

NARRATIVE

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[CONTINUED FROM LIC 9099]

Per interview of credible outside source, Person #1 (P1): R1 had a history of hoarding and misplacing objects inside their own bedroom (rather than those items being taken/stolen), and R1’s memory had worsened over time. Long before March 2022, P1 installed a video camera inside R1’s bedroom. Each time R1 thought something was missing from their bedroom, P1 reviewed the camera footage and found nothing suspicious. On a date after the time frame of the complaint allegation, P1 helped R1 move from the facility’s independent living area to their memory care area. While clearing out R1’s bedroom, P1 located R1’s electric razor and most of the costume jewelry that was alleged stolen.

CCLD interviewed four (4) staff who were familiar with R1’s time at the facility. Staff #1 (S1) said R1 was “very forgetful” and known to report items as stolen from their bedroom, then later find them. Staff #2 (S2) recalled handing a letter to R1, who then misplaced it and thought a housekeeper stole it, before finding it again. Staff #3 (S3) recalled an occasion where R1 thought staff stole gift cards from their room, and an occasion where R1 thought staff stole their house keys; on both occasions, R1 later found these items themselves. Staff #4 (S4) said R1 often misplaced their hearing aids, which staff usually found inside their bedroom or bathroom.

Based on interviews and records, a preponderance of evidence does not exist to prove that facility staff took R1’s personal property. The allegation is therefore unsubstantiated.

An exit interview was conducted with Jones, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023

LIC9099 (FAS) - (06/04)

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