374604063-7-21-2022-08-AS-IESA-CHU349-20220831175445

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604063
Report Date: 07/21/2022
Date Signed: 07/21/2022 07:26:29 PM

Substantiated

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
09/23/2021 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20210923092822

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:	03:00 PM
MET WITH:	Administrator Genoveva Guerrero		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility staff financially abused resident.

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 arrived later during the visit.

It was alleged that facility staff financially abused Resident #1 (R1), specifically because: a) staff took R1’s debit card and made unauthorized charges on it, and b) staff took R1 to their bank on two occasions to withdraw large sums of cash (which was unusual for R1). [See LIC811 Confidential Names List for a description of person identifiers used in this report.] CCLD’s investigation involved an unannounced facility tour/welfare check, interviews of pertinent staff and residents, and review of relevant facility billing, resident banking, and merchant transaction records. The Department also reviewed excerpts of bank video surveillance and reports from the fraud / asset protection department of R1’s banking institution and local law enforcement. [CONTINUED ON LIC 9099-C, 1 of 2]

Substantiated

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)

Page: 1 of 4

Control Number 08-AS-20210923092822

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 9099]

Interview of R1 and review of their facility care records revealed that they were alert and aware, with no memory deficit; their testimony was reliable. R1 said they alerted their bank in September 2021, when they first suspected unauthorized charges were made on their debit card. Bank records corroborated this, further revealing from August through November 2021, there were 31 unauthorized charges on R1’s debit card(s), totaling $1,169.13. The charges included digital media purchases from Apple, merchandise from Nike and Shein, fast food deliveries from GrubHub and UberEats, and ride-share services from Lyft and Uber. Some charges involved pick up and/or delivery direct to the facility’s address, while others occurred in Mexico.

Subpoenaed merchant transaction records showed facility Staff #1 (S1) was the customer who made the unauthorized charges. Merchants provided S1’s full name, phone number, E-mail address, and IP addresses, which were matched against a government database, producing S1’s social security number. Data from these outside sources matched S1’s profile in CCLD’s background clearance database, providing a positive identification. Facility and CCLD records show that S1 was an employee of the licensee during the period that the unauthorized charges were made on R1’s debit card(s). S1, when interviewed at the facility, denied any involvement. Nonetheless, R1’s financial institution concluded fraud occurred and refunded R1 the unauthorized charges.

Regarding complainant’s concern about the two large in-person cash withdrawals from R1’s bank account, CCLD determined they did not constitute abuse. [Resident #2 (R2) is R1’s spouse and lives with R1 at the facility.] Interviews of R1, R2, and facility staff unanimously revealed that R1 sought to save money. Licensee offered them a 5% discount for paying their monthly rent in cash (instead of by check). R1 utilized this discount for two months, then reverted to paying by check starting in October 2021. Interviews and bank surveillance footage depict facility staff accompanying R2 to the bank, once in August 2021 and once in September 2021, to withdraw cash. On both occasions, R1 phoned the bank management in advance to verbally approve the withdrawals. R1 was confident that the withdrawn cash was accurately applied to the facility’s rent charges for themselves and their spouse. CCLD studied the facility’s invoices and payment receipts for R1 and R2, comparing them against the bank’s record of R1’s cashed checks made out to the facility. CCLD found no evidence of theft here, concluding that the financial records reinforced the common narrative described in interviews. [CONTINUED FROM 9099-C, 2 of 2]

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)

Page: 4 of 4

Control Number 08-AS-20210923092822

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-C, 1 of 2]

Based on interviews and records, the preponderance of evidence shows that a particular facility employee (S1) financially abused a particular resident (R1) in care. The allegation is therefore substantiated. A deficiency is cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with Guerrero, to whom a copy of this report, the LIC811 Confidential Names List, 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)

Page: 2 of 4

Control Number 08-AS-20210923092822

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/21/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/22/2022 Section Cited CCR 87468.2(a)(8)	1 2 3 4 5 6 7	87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: “(a)…residents in privately operated residential care facilities shall have all of the following rights: …(8) To be free from…financial exploitation…” This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	Licensee reviewed the matter and made an independent decision to terminate S1’s employment effective 07-22-2022. This resolves the immediate threat to residents in care. Licensee agreed to utilize an outside source to coordinate the retraining of its remaining staff on these topics: a) Resident’s Personal Rights, b) Resident Abuse and Neglect Prevention, and c) Mandated Reporter requirements. Upon training completion, Licensee agreed to submit to LPA the training sign-in sheet as proof.
	8 9 10 11 12 13 14	Based on interviews and records, licensee did not ensure that resident (R1) was free from the financial exploitation of their staff (S1), while R1 was under licensee’s supervision. This posed an immediate personal rights risk to 1 of 28 residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

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 appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC9099 (FAS) - (06/04)

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