374604083-2-26-2020-08-AS-SJAB-BM8N4T-20200228090828

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604083
Report Date: 02/25/2020
Date Signed: 02/26/2020 02:53:58 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
10/05/2019 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20191005095041

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:	03:31 PM
MET WITH:	Associate Executive Director, Kellie Shearer		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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9

Facility is restraining resident against his will.

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 a resident record review.

In regard to the above allegation, the RP reported R1 was being held at the facility against his will. An interview with R1 revealed that there was a miscommunication with the RP. R1 is aware he is allowed to leave the facility with assistance. R1 was not referring to facility staff when conversing with the RP. Interviews with facility Staff confirmed R1 is allowed to leave the facility with assistance. There are no witnesses of any restraints being placed on any of the residents.

Based facility staff and resident interviews the above allegation is determined unsubstantiated. An exit interview was conducted, and a copy of this report was left at the facility with Associate Executive Director, Kellie Shearer who was provided a copy of the Appeal Rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights.

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: 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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