374604062-4-15-2021-08-AS-DPOL-C2L364-20210430175740

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604062
Report Date: 04/15/2021
Date Signed: 04/15/2021 02:33:06 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
07/01/2020 and conducted by Evaluator Elizabeth Hamilton

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20200701081644

FACILITY NAME:	ELMCROFT OF POINT LOMA		FACILITY NUMBER:	374604062
ADMINISTRATOR:	KAREN ROPER		FACILITY TYPE:	740
ADDRESS:	3423 CHANNEL WAY		TELEPHONE:	(619) 224-7300
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92110
CAPACITY:	60	CENSUS: 34	DATE:	04/15/2021
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Executive Director, Kellie Shearer		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Unlawful Eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced complaint investigation virtual visit via FaceTime due to COVID-19. LPA identified herself and discussed the purpose of the visit, which was to deliver findings for the above allegation with Executive Director, Kellie Shearer.

The Department’s investigation consisted of interviewing outside sources and reviewing records.

It was alleged that on July 1, 2020, staff unlawfully evicted R1 (R1 – See LIC 811 Confidential Names List) from the facility by refusing to accept R1 back from the hospital. Based on medical records, on July 1, 2020, at 12:33 am, R1 was admitted to the Hospital’s Emergency Department for a non-COVID-19 related illness. Interviews revealed although a COVID-19 test may have been requested by the facility, R1 returned to the facility the same morning without receiving a negative COVID-19 test result. Medical records dated July 1, 2020, revealed R1 was discharged from the hospital at 9:23 am and returned to the facility by ambulance.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Elizabeth Hamilton	TELEPHONE: (619) 929-7590
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021

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-20200701081644

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: ELMCROFT OF POINT LOMA	FACILITY NUMBER: 374604062
	VISIT DATE: 04/15/2021

NARRATIVE

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R1 was accepted by staff into care. Based on records reviewed, there was no evidence of a written eviction notice given to R1 by the facility although a conversation was had.

The Department has investigated the alleged unlawful eviction. Based on the evidence obtained, including interviews and records reviewed the allegation is unsubstantiated as the Department could not meet the preponderance of evidence standard.

An exit interview was conducted with Executive Director via FaceTime and a copy of this report, confidential names list and Licensee/Appeal Rights (LIC 9058 01/16) was provided to Executive Director via email. An electronic receipt of confirmation was requested to be sent by the Licensee upon receipt of the documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Elizabeth Hamilton	TELEPHONE: (619) 929-7590
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021

LIC9099 (FAS) - (06/04)

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