374604083-11-9-2023-08-AS-SJAB-CY3Q3Z-20231130104936

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604083
Report Date: 11/08/2023
Date Signed: 11/09/2023 08:02:36 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
12/31/2020 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20201231150041

FACILITY NAME:	MONTERA, THE		FACILITY NUMBER:	374604083
ADMINISTRATOR:	JUDITH PIERFAX		FACILITY TYPE:	740
ADDRESS:	5740 LAKE MURRAY BLVD		TELEPHONE:	(619) 832-2599
CITY:	LA MESA	STATE: CA	ZIP CODE:	91942
CAPACITY:	225	CENSUS: 189	DATE:	11/08/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Business Office Manager (BOM) Melody Veal		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Resident's room is unsanitary.
Resident left in soiled undergarments.
Facility staff did not seek medical attention for resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to conclude a complaint investigation regarding the above-mentioned allegations. LPA Correia met with Business Office Manager Melody Veal, identified herself, and explained the purpose of the visit.

The Department’s investigation consisted of facility and resident record reviews, as well as outside sources, and resident interviews.

A resident records review revealed Resident 1 (R1) was admitted to the facility on March 19, 2019, with a primary diagnosis of Hypertension Congestive Heart Failure, and was in fair health. On December 30, 2020, Community Care Licensing (CCL) received a complaint alleging R1’s room was unsanitary. A facility records review revealed during this time, the facility was experiencing an undertaking of a COVID-19 outbreak and had contracted with an outside agency to maintain adequate staffing to ensure the residents received the proper care and supervision. Interviews conducted with residents revealed no complaints regarding the care or cleanliness of the facility, with some residents stating the facility staff have been extremely great, and attentive to their needs.

Unsubstantiated

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: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

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-20201231150041

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: 11/08/2023

NARRATIVE

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Interviews conducted with residents revealed no complaints regarding the care or cleanliness of the facility, with some residents stating the facility staff have been extremely great, and attentive to their needs. Interviews conducted with outside sources also revealed no complaints. During this time, CCL records revealed being in daily contact with facility staff to confirm they were properly staffed, had adequate equipment and resources, including cleaning supplies for sanitizing the facility.

It was also alleged that R1 was left in soiled undergarments. A resident records review revealed R1 was embarrassed to request for toileting assistance and staff were to encourage R1 to use their pendant. Records also revealed during staff checks there was documentation of several refusals by R1 for toileting assistance, and notation of staff encouraging R1 to seek staff’s help for toileting.

Lastly, it was alleged that staff did not seek medical attention for R1. Facility records revealed R1 received multiple checks a day, staff documented R1’s status during each check, and if any changes in conditions were observed, or R1 had any complaints staff documented contacting R1’s Primary Care Physician (PCP) and updating R1’s care plan as needed. On December 5, 2020, a short time before the complaint was filed R1 complained of discomfort while urinating, staff sent R1 to the hospital that day and was treated for a UTI.

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

An exit interview was conducted, Appeal Rights (LIC 9098 01/16) along with a copy of this report was provided to BOM Veal and signature on this form 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: 11/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023

LIC9099 (FAS) - (06/04)

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