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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604100
Report Date: 05/01/2024
Date Signed: 05/01/2024 01:00:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/12/2020 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20200812143839
FACILITY NAME:CASA DEL SOL RTF IIFACILITY NUMBER:
374604100
ADMINISTRATOR:VASQUEZ, MANUELFACILITY TYPE:
735
ADDRESS:1141 JULIETTE PLTELEPHONE:
(619) 405-7750
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY:4CENSUS: 0DATE:
05/01/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Manuel Vazquez, Licensee/Administrator TIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility mishandling clients medication.
Facility mishandling clients personal funds.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to deliver findings for the allegations noted above. LPA met with Licensee Manuel Vazquez and explained the purpose of the visit. The investigation included observations interviews and record reviews.

It was alleged the facility was mishandling clients’ medication because over the counter medications did not have prescriptions, clients were paying for their own medications, medication bottle labels were altered, expired PRNs were still being used, PRN medications were being administered when they were not needed, and staff were not administering medications as prescribed because they were administered late or missed all together. It was further alleged medications were being stored in empty old bottles and missed medications were not being reported. LPA conducted a review of over-the-counter medications on 12/28/2023 and observed two over-the-counter medications (M1 & M2) that were used for Client #1 (C1) there were no prescriptions available for either. LPA conducted a review of client records and did not locate a prescription for M1 or M2. Licensee interview confirmed M1 and M2 were administered to C1 as

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
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 6
Control Number 08-AS-20200812143839
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: CASA DEL SOL RTF II
FACILITY NUMBER: 374604100
VISIT DATE: 05/01/2024
NARRATIVE
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well as confirming the licensee did not have prescriptions.

A review of clients’ P&I logs dated May 2020-July 2020 revealed clients were making purchases from a pharmacy. Per an interview with the Licensee the purchases at the pharmacy are for co-pays related to the client’s medication, that are not covered by the insurance. LPA reviewed the clients’ medication bottles on 12/28/2023 and did not observe any altered medication labels. The review on 12/28/2023 did not reveal any expired medications. The LPA requested documents to verify if there were any missed or late administrations of medication in or around August of 2020, however, the LPA was not successful in obtaining any documents. The licensee denies medication was missed or given late. The review of medications on 12/28/2023 did not reveal any medications were being stored outside of their original packaging. In addition, the licensee denies storing medications outside of their original packaging. LPA conducted a facility file review which revealed that there were not any unusual Incident/Injury reports pertaining to medication errors reported. The licensee confirmed there were no reports as medication was not missed. Based on interviews with staff the medications were given as prescribed. Based on the residents being given over the counter medications without the proper medical consent/order, the allegation of facility is mismanaging clients medication is substantiated.

Facility mishandling clients personal funds was alleged the facility was mishandling clients’ personal funds because the licensee was writing the clients initials on the Personal and Incidental (P&I) logs rather than the clients initialing themselves. LPA reviewed P&I logs dated between May 2020 and July 2020. Licensee interview revealed the licensee denies initialing the logs on the client’s behalf. The licensee reports he was using hand-over-hand techniques to assist clients in initialing the P&I logs. The LPA conducted an interview with a relevant third party who confirmed an audit was conducted in November of 2020 which did not result in any issues or concerns about mishandling of clients’ personal funds. Regarding cutting the clients hair and charging them for it, what was alleged is true as a self-admission from Licensee Manuel Vazquez stated that on one occasion believed to have occurred sometime in 2020, as the barbershops were closed due to the state of emergency due to Covid-19, and due to the behaviors that the clients were exhibiting while having to wait to have their hair cut hair cuts were done at the facility by Vazquez. Per Vazquez each client was charged a one time fee of either $13.00 or $14.00 that went towards the clippers that were purchased and used to do the haircuts. LPA observed a P&I log dated May 2020 showing C1 being charged $13.00 for a haircut, however there was no receipt attached. LPA reviewed P& I logs dated August 2023-April
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 08-AS-20200812143839
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: CASA DEL SOL RTF II
FACILITY NUMBER: 374604100
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2024
Section Cited
CCR
80075(5)(A)
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Health Related Services (5) If the client's physician has stated in writing that the client is unable to determine his/her own need for nonprescription medication...(A) There is a written direction from a physician, on a prescription blank, specifying the name of the client, the nam of the medication
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The licensee agrees to obtain medical authorization from client's physician allowing over the counter medications to be given as needed. POC is to the department by 5pm on the due date indicated.
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This requirement is not met as evidenced by: the licensee did not ensure that consent was obtained to from C1 and C2's physician to give over the counter medications. This posed a potential health, safety and personal rights risk to persons in care.
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Type B
05/15/2024
Section Cited
CCR
80026(A)(1)
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(1) Records of clients' cash resources maintained as a drawing account, which shall include a current ledger accounting, with columns for income, disbursements and balance, for each client. Supporting receipts for purchases shall be filed in chronological order.
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The licensee agrees to conduct an inservice on P&I and the importance of keeping receipts and documentation. POC is to be submitted to the department by 5pm on the due date indicated.
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(A)Receipts for cash provided to any client from his/her account. This requirement is not met as evidenced by: the licensee did not ensure an accurate account was kept to verify purchase of clippers for C1, C2 C3. This poses a potential health, safety and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/12/2020 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20200812143839

FACILITY NAME:CASA DEL SOL RTF IIFACILITY NUMBER:
374604100
ADMINISTRATOR:VASQUEZ, MANUELFACILITY TYPE:
735
ADDRESS:1141 JULIETTE PLTELEPHONE:
(619) 405-7750
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY:4CENSUS: 0DATE:
05/01/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Manuel Vazquez, Licensee/AdministratorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility staff do not meet minimum qualifications required by licensing
Furniture is in disrepair
Inadequate food service
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to deliver findings for the allegations noted above. LPA met with Licensee Manuel Vazquez and explained the purpose of the visit. The investigation included observations interviews and record reviews.

Facility staff do not meet minimum qualifications required by licensing.
It was alleged facility staff do not meet minimum qualifications because they don’t have required experience, don’t have required certifications and are administering medications without training. LPA conducted a file review of six (6) facility staff that were employed at the facility at the time the complaint was received. Per staff interviews the training received also included shadowing the Licensee/Administrator. The placing agency has a requirement of obtaining the Direct Support Professional training to be obtained within a year of employment. Five (5) of the six (6) staff met the requirements, there was one (1) staff that required additional time as they did not pass the first time, however the certification was eventually obtained within a year of being hired. LPA observed that all six
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 08-AS-20200812143839
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: CASA DEL SOL RTF II
FACILITY NUMBER: 374604100
VISIT DATE: 05/01/2024
NARRATIVE
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(6) of the staff completed the initial 16 hours of training which included: medication (self-administration of medication, and safekeeping of medication). LPA reviewed staff training records for the facility staff to receive on-going training which included ARF medication training, and medication and documentation training.In addition LPA reviewed interviews conducted for another open complaint associated with the facility. The interviews revealed that staff was given training's, which included hands on training given by the Licensee Manuel Vazquez and the eventually the training became minimal. Additional staff interviews conducted revealed that staff felt that they were adequately trained. Based on interviews and records review the allegations are unsubstantiated.

It was alleged the facility was overcrowded with furniture which posed a risk to the clients. Per an interview with the Licensee Manuel Vazquez, he could not recall if he was moving and had brought furniture from his home to be stored at the facility in between moves. The licensee interview revealed there were always clear passageways and there were no incidents of clients being injured or tripping over furniture. Additional staff interviews were conducted where 3 of 3 revealed they were working in or around August of 2020. In addition, 3 of 3 staff interviews revealed they could not recall a time the facility had an excess amount of furniture. In one of the staff interviews staff could not recall if any of the resident’s sustained an injury due to the excess of furniture. LPA attempted to interview clients but was unsuccessful. LPA was unable to obtain evidence to corroborate or refute the allegation. Therefore, the allegation is unsubstantiated.

It was alleged facility has inadequate food service because the majority of the groceries purchased are frozen pre-cooked foods that only require heating it up and there is only one package of chicken with no other types of meat served. LPA conducted a tour of the facility on 12/28/23, and LPA observed for the facility food supply to meet the minimum requirements of a 2-day supply of perishable food items and a 7-day supply of nonperishable food items. An interview with staff working at the facility in or around August of 2020 revealed 1 of 1 interview revealed that meals were freshly prepared. LPA attempted to interview clients but was unsuccessful. LPA was unable to obtain evidence to corroborate or refute the allegation. There is insufficient evidence to corroborate or refute what was alleged. Therefore the allegation is unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation(s) occurred.



An exit interview was conducted, and a copy of this report was provided to Licensee Manuel Vazquez.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 08-AS-20200812143839
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: CASA DEL SOL RTF II
FACILITY NUMBER: 374604100
VISIT DATE: 05/01/2024
NARRATIVE
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2024 and there were no charges additional for hair cuts observed. Therefore the allegation of facility is mismanaging client funds is substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted and a copy of this report, 9099D, appeal rights, LIC9098-proof of corrections form was provided to Manuel Vazquez, Licensee/Administrator.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6