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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604100
Report Date: 08/25/2025
Date Signed: 08/25/2025 01:18:12 PM

Unsubstantiated


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
10/27/2022 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20221027220204
FACILITY NAME:CASA DEL SOL RTF IIFACILITY NUMBER:
374604100
ADMINISTRATOR:VASQUEZ, MANUELFACILITY TYPE:
735
ADDRESS:1141 JULIETTE PLTELEPHONE:
(760) 645-3195
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY:4CENSUS: 0DATE:
08/25/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Manuel Vazquez, Licensee/administratorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff neglect resulted in client hospitalization.
Staff failed to obtain timely medical attention.
Staff failed to follow reporting requirements.
Staff failed to meet residents need; resident had unexplained brusing.
INVESTIGATION FINDINGS:
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On 08/25/25 Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to deliver findings for the allegation listed above. LPA met with Licensee Manuel Vazquez and explained the purpose of the visit, and the elements of the allegations. The investigation consisted of interviews, and records review.

Regarding the allegation of Staff neglect resulted in client hospitalization.It was alleged that C1 had a fall on or around August 2021. A third-party witness stated that contact was made with the facility staff via telephone where it was reported that C1 had a fall, and that it was unknown if they hit their head. There was no documentation supporting that C1 had a fall in or around August 2021, however C1 did have a fall on 10/09/2021, where they were sent out and had a medical evaluation. Per a further record review medical record visit form revealed that on 03/18/2021 C1 was noted/described by staff to be lethargic, sleepy, confused and having difficulty controlling their body. C1 was sent out the same day and did end up being hospitalized. Due to insufficient evidence the allegation of staff neglect resulted in client
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
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 3
Control Number 18-AS-20221027220204
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: 08/25/2025
NARRATIVE
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hospitalization is unsubstantiated.

Staff failed to obtain timely medical attention.

On October 28, 2022, it was alleged that Client #1 (C1) sustained a fall on or about August 2021 resulting in a Subarachnoid bleed. Per Mayo Clinic “A subarachnoid hemorrhage is bleeding in the space between the brain and the tissues that cover the brain. The space is known as the subarachnoid space. A subarachnoid hemorrhage is a type of stroke. It is a medical emergency that needs treatment right away”. An interview conducted with a third-party witness revealed that on March 18, 2021, C1 was sent to the hospital by Licensee Manuel Vazquez as C1 was displaying confusion and lack of energy. Per scans conducted revealed C1 to have a small aneurism in front on the left side of their head. A specialist ordered C1 to wear a helmet and discharged C1 back to the facility on March 23, 2021. A review of facility notes revealed that there was no record that indicated that R1 had a fall in August 2021, resulting in a Subarachnoid bleed. There is no record or recollection from any witnesses interviewed to support that C1 had a fall in August 2021 resulting in C1 sustaining a subarachnoid bleed. Based on insufficient evidence to support the allegation, the allegation of Staff failed to obtain timely medical attention is unsubstantiated.

Staff failed to follow reporting requirements.


It was alleged that some things would not get reported in a timely manner pertaining to the clients, and there would be no follow up on recommendations for client care. It was alleged that Client #1 (C1) would become constipated, as there were times when they did not have a bowel movement for up to five days. It was recommended to have C1, sent out for further medical evaluation by the facility’s Nurse Consultant. LPA reviewed a Special Incident Report (SIR) dated 07/14/2021 that notes C1 was seen at the emergency room due to constipation, with the after-care visit summary attached. The SIR does not state how many days C1 had been constipated for. Upon further records review of a special incident report (SIR) dated 10/09/2021 revealed C1 had a fall and was sent out for a medical evaluation the same day. This was corroborated by the aftercare visit summary dated 10/19/2021. There was no further documentation to review that would support that the facility did not seek timely medical attention in a timely manner therefore the allegation is unsubstantiated.
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20221027220204
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: 08/25/2025
NARRATIVE
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Staff failed to meet residents need; resident had unexplained bruising.

It was alleged that there were instances where facility staff allegedly failed to meet the Client #1 needs as they were observed with having unexplained bruising. Regarding Client #1 (C1) is diagnosed with unsteady gait and per their physician’s report and Individual Program Plan (IPP) C1 requires constant supervision when walking to avoid falling. C1 also has a neurocognitive disorder that requires for them to wear a helmet to avoid injuries and maintain safety. An interview with a third-party witness revealed that on or about August 2021, facility staff reported C1 having a fall, resulting in a bruise to their lower back. Licensee Vasquez reported that he had assessed C1, and they were fine. However, on March 2, 2022, C1, was sent out to the hospital a couple days later for an unrelated matter. Per Licensee Vasquez C1 was sent to the hospital due to an existing chronic medical condition.


Additionally, LPA conducted a records review of the facility Nurse’s notes for clients in care dated from March 2020 through September 2021. Per the Nurse’s notes dated 03/30/2020, Client #2 (C2) was noted to have bruising to left upper ear lobe and C2 could not provide information on what happened. On Nurse’s notes dated 06/20/2020 C2 was noted to have discoloration to their right hip and posterior right thigh, C2 was not sure what happened. Nurse’s notes dated 03/09/2021 C2 was noted to have bruising and discoloration to their forearms, as well as a circular mark to their posterior left extremity, C1 was unable to state how the bruising and circular mark was sustained, as they did not provide a response when asked. Nurse’s notes dated 09/01/2021 C2 was noted to have discoloration to posterior left shoulder and left lateral midback, C2 was noted to be unable to recall what happened. Nurse’s notes dated 09/13/2021 C2 was noted to have discoloration to their left orbit and is noted to not recall what happened. Other notes reviewed revealed that there were incidences where C2 was noted to have scratches, bruising, and scabbing to their bottom lip, in these instances C2 was able to state/recall what happened. Per the Nurse’s notes reviewed revealed that there were instances where staff provided and explanation for the injuries and other times when they did not. Per an interview with the Licensee/Administrator Vasquez the bruising and other injuries were discounted as being associated or a result of when clients would have behaviors and became agitated.

Based on insufficient evidence to refute or corroborate evidence the allegation of Staff failed to meet residents need; resident had unexplained bruising 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, and LIC811-Confidential names list was reviewed and provided to Manuel Vasquez, Licensee/Administrator.
SUPERVISORS NAME: Carolyn Tuba
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3