374604083-2-26-2020-08-AS-SJAB-BM8MWL-20200228085832

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604083
Report Date: 02/25/2020
Date Signed: 02/26/2020 03:06:04 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
09/06/2019 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20190906134832

FACILITY NAME:	MONTERA, THE		FACILITY NUMBER:	374604083
ADMINISTRATOR:	BECK, KRISTIN		FACILITY TYPE:	740
ADDRESS:	5740 LAKE MURRAY BLVD		TELEPHONE:	(949) 242-1400
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	225	CENSUS: 82	DATE:	02/25/2020
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Associate Executive Director, Kellie Shearer		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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New Admissions Agreement does not follow regulatory requirements.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to deliver investigative findings on the above listed complaint allegation. LPA was met and granted entry into the facility by Associate Executive Director, Kellie Shearer to whom was informed of the purpose for the visit.

The Department’s investigation consisted of staff and resident interviews. It also consisted of facility, and resident records review.

In regard to the above allegation, on July 6, 2018 The Montera underwent a change in ownership. Each resident was provided a notification letter of change in ownership on March, 21 2018. The new owner submitted all changes in services, and related documents including the new Admission Agreement to CAB for review and approval to ensure all facility procedures and protocols meet regulatory requirement as set forth by Title 22. On October 14, 2019, R1 was provided a new Admission Agreement for review and signature. Regulatory requirements 87507(a)(4) states the licensee shall allow each resident 60 days to review any modifications made to the Admission Agreement. Facility staff has made several attempts (face to face and via email) to obtain R1’s signature. On January 17, 2020 R1 received a final warning with a due date of January 31, 2020 for signature, or the facility will be terminating his residency. To date the facility has allowed R1 to remain at the facility, affording R1 more time than the required time, mandated by Title 22, to agree to the new terms of the Admission Agreement or find alternative placement.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Debbie Correia	TELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

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-20190906134832

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: MONTERA, THE	FACILITY NUMBER: 374604083
	VISIT DATE: 02/25/2020

NARRATIVE

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Based on resident and facility records the above allegation is determined to be unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Associate Executive Director, Kellie Shearer and a copy of this report and Appeal Rights (LIC 9058) have been given to Associate Executive Director, Kellie Shearer whose signature below confirms receipt of these rights.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Debbie Correia	TELEPHONE: (619) 407-0894
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC9099 (FAS) - (06/04)

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