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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604087
Report Date: 06/19/2024
Date Signed: 06/19/2024 01:15:19 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
07/24/2023 and conducted by Evaluator Dawn Segura
COMPLAINT CONTROL NUMBER: 08-AS-20230724113611
FACILITY NAME:MOUNTAIN VIEW HOME-DEL VISTA WAYFACILITY NUMBER:
374604087
ADMINISTRATOR:RUSSELL, KATRINAFACILITY TYPE:
735
ADDRESS:16350 DEL VISTA WAYTELEPHONE:
(619) 419-9938
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:4CENSUS: 1DATE:
06/19/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lauren RussellTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Licensee interfered with communications between client and client's medical provider.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigation findings. LPA was granted entry into the facility and met with Lauren Russell, to whom LPA disclosed the reason for the visit.

It was reported to Community Care Licensing (CCL) that the licensee coached Client 1 (C1) to request an increase in medication and, subsequently, coached C1 to request a new psychiatrist when the medication was not increased.

CCL has investigated the above-listed complaint allegation. The investigation consisted of a tour of the facility, review of facility and outside source records, and interviews of C1, staff, and outside sources.

Interviews conducted during the investigation yielded that C1 experienced increased behavioral changes for which psychiatric intervention was sought. During the engagements with C1’s psychiatrist at the time, a
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20230724113611
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: MOUNTAIN VIEW HOME-DEL VISTA WAY
FACILITY NUMBER: 374604087
VISIT DATE: 06/19/2024
NARRATIVE
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change in medication was implemented. LPA was not able to determine if the need or request for the change was initiated by the psychiatrist, licensee, or C1; however, evidence obtained during the investigation revealed that, after discussion with C1’s psychiatrist, C1, who is very high functioning, requested an increase in dosage of anxiety medication. LPA was able to determine that there were exchanges between the licensee and psychiatrist and/or personnel of the psychiatrist’s office that were not amicable. Despite the inability of the licensee and C1’s psychiatrist to maintain an agreeable relationship, the investigation did not yield evidence to conclude that the licensee interfered with communications between C1 and C1’s psychiatrist.

Based upon a lack of sufficient evidence to corroborate the allegation, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted with Lauren Russell, and a copy of this report and Licensee/Appeal Rights (LIC 9058) were provided to the staff at the conclusion of the visit.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2