374604065-12-21-2022-08-AS-JRAE-CMLPCA-20221230101135

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604065
Report Date: 12/21/2022
Date Signed: 12/21/2022 10:57:21 AM

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
12/13/2022 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20221213120047

FACILITY NAME:	LAGUNA ESTATES SENIOR LIVING		FACILITY NUMBER:	374604065
ADMINISTRATOR:	WESLEY LAVENDER		FACILITY TYPE:	740
ADDRESS:	1088 LAGUNA DRIVE		TELEPHONE:	(760) 434-7116
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	214	CENSUS: 107	DATE:	12/21/2022
		UNANNOUNCED	TIME BEGAN:	10:41 AM
MET WITH:	Wesley Lavender		TIME COMPLETED:	11:05 AM

ALLEGATION(S):

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Licensee did not keep facility free from rodents

Licensee did not maintain facility in good repair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver findings on the above allegations. LPA met with Executive Director Wesley Lavender and discussed the elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegations. The investigation consisted of LPA direct observation, records review, and interviews.

It was alleged that Licensee did not keep facility free from rodents. Interview with resident revealed rodent traps were set in different areas around their apartment resulting in the capture of one rodent. The resident stated they felt relieved that the pest issue was being handled by a professional company. Interview with Executive Director revealed on December 5, 2022, a resident noted droppings and other signs of a rodent in their apartment. The facility engineering team then placed baited glue traps in the resident’s apartment. On December 6, 2022 a third-party pest control company was contacted regarding a possible rodent in a resident’s apartment. On December 7, 2022 a third-party pest control company arrived at the facility and placed more glue traps and mechanical traps in the resident’s apartment.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022

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-20221213120047

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: LAGUNA ESTATES SENIOR LIVING	FACILITY NUMBER: 374604065
	VISIT DATE: 12/21/2022

NARRATIVE

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On December 15, 2022 a third-party pest control company arrived and removed a rodent from the resident’s apartment. Records review revealed the facility hired a third-party pest control company with services beginning on December 7, 2022.

It was alleged that Licensee did not maintain facility in good repair, resulting in the memory care keypad not working. On December 19, 2022 LPA Serrano observed a facility staff member positioned at the memory care entrance. The staff member stated they were positioned at the door monitoring who entered and exited the memory care unit. LPA Serrano also observed the memory care keypad was taped over and not in use. The exit alert on the door (“screamer”) was functioning and in working order. Interview with Executive Director revealed the memory care entrance door is monitored by a staff member from 6am-10pm. During the night shift the exit alert (“screamer”) is activated. Records review revealed ongoing technical issues with the memory care keypad device. Furthermore the facility appears to be actively working with a third-party security door company on resolving the issue.

Based on LPA observations, records review and interviews, we have found that the preponderance of the evidence standard has not been met, therefore, the allegation is found to be unsubstantiated.

An exit interview was conducted with Wesley Lavender and a copy of this report and Licensee/Appeal Rights (LIC 9058) were provided to Wesley Lavender whose signature below confirms receipt of documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022

LIC9099 (FAS) - (06/04)

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