374604063-7-21-2022-08-AS-LTEZ-CGRU87-20220728152104

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604063
Report Date: 07/21/2022
Date Signed: 07/21/2022 07:15:53 PM

Unfounded

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
11/10/2021 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20211110155911

FACILITY NAME:	MESAVIEW SENIOR ASSISTED LIVING		FACILITY NUMBER:	374604063
ADMINISTRATOR:	GENOVEVA GUERRERO		FACILITY TYPE:	740
ADDRESS:	7971 CULOWEE STREET		TELEPHONE:	(619) 466-0253
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	30	CENSUS: 28	DATE:	07/21/2022
		UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Administrator Genoveva Guerrero		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Licensee did not enable resident access to telephone.

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 and identified himself to Med Tech Fabiola Reyes. LPA then met with and discussed the purpose of the visit with Administrator Genoveva Guerrero, who arrrived later during the visit.

It was alleged that licensee did not allow Resident #1 (R1), who does not own a cell phone, to use the facility’s telephone to make or receive calls. As a result, R1 was “completely cut off.” CCLD’s investigation consisted of an unannounced facility tour/welfare check, a test of the facility’s phone, review of R1 medical records, and interview of R1, their spouse/Power of Attorney (POA), and pertinent facility staff and outside sources.

[CONTINUED ON LIC 9099-C]

Unfounded

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: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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-20211110155911

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: MESAVIEW SENIOR ASSISTED LIVING	FACILITY NUMBER: 374604063
	VISIT DATE: 07/21/2022

NARRATIVE

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[CONTINUED FROM LIC 9099]

During a 11-16-2021 visit to commence the complaint investigation, LPA sought to interview R1, but respectfully waited for them to first complete a phone call they were on before approaching them. For around 15 minutes, LPA observed R1 sitting in a shaded area of the facility’s courtyard in relative privacy, holding the facility’s cordless phone to their ear and speaking on it. After the call, LPA helped R1 hail down a staff member to hand the phone back to them.

Based on LPA’s interview of R1 about many topics (lasting over an hour), R1 appeared fully alert and oriented with no apparent memory loss. According to R1, they never owned a cell phone while living at the facility (“because it is too complicated [to use]”). R1 said they regularly use the facility telephone to receive incoming calls, and that their spouse/POA calls them on it in the afternoon, either every day or every other day. R1 said that they rarely choose to make outgoing calls, for fear that the phone line could be tapped/recorded by staff. [According to R1’s medical records, their physician said they have a history of “paranoid behavior.”] R1 said facility staff have never denied them use of the facility phone for either incoming or outgoing calls. R1’s statements about their access to and use of the facility telephone were unanimously corroborated by their spouse/POA, facility staff, and outside sources. According to the licensee, they pay for a second phone landline for the exclusive use of the residents, so that they can speak at length with their loved ones without worrying that they are tying up the business’ phone line.

Based on records and interviews, the allegation that licensee did not enable R1’s access to the telephone is unfounded, meaning it was false, could not have happened, and/or is without a reasonable basis. We have therefore dismissed the allegation. An exit interview was conducted with the Guerrero, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dang Nguyen	TELEPHONE: (619) 210-9024
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC9099 (FAS) - (06/04)

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