374604065-3-2-2023-08-AS-DPOL-CPJV2E-20230302150257

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604065
Report Date: 02/28/2023
Date Signed: 03/02/2023 02:37:16 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
01/26/2023 and conducted by Evaluator Liliana Silveira

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230126162508

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: 111	DATE:	02/28/2023
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Executive Director Wesley Lavender		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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-Facility did not provide hot water.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Liliana Silveira conducted a complaint investigation visit to deliver findings for the above-mentioned allegation. LPA Silveira met with Executive Director Wes Lavender and shared the findings.

The Department’s investigation consisted of interviews and records review. On 1/26/23, it was alleged that the facility did not provide hot water. Interviews with staff and the Executive Director revealed that on 01/25/23 it was discovered that hot water was not working in building B. A records review revealed that a plumbing service was contracted and a new water pump had to be ordered. Interviews with staff, residents and the Executive Director revealed that interim showers were being provided for the residents in building A while the pump was being fixed. The new water pump was installed on 01/27/23 and the hot water was back in service on that same day.
(CONTINUED ON LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2023

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-20230126162508

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: 02/28/2023

NARRATIVE

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Due to lack of corroborating evidence, the findings regarding the above allegation were established to be unsubstantiated. This finding means that although the allegation may have happened or could be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

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: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

LIC9099 (FAS) - (06/04)

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