374604103-7-31-2024-08-AS-IESA-D7Q8KY-20240731223554

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604103
Report Date: 07/31/2024
Date Signed: 07/31/2024 03:35:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
06/14/2021 and conducted by Evaluator Becky Kennedy

COMPLAINT CONTROL NUMBER: 08-AS-20210614145110

FACILITY NAME:	SIENNA AT OTAY RANCH SENIOR LIVING		FACILITY NUMBER:	374604103
ADMINISTRATOR:	REBECCA WILLIAMS		FACILITY TYPE:	740
ADDRESS:	1290 SANTA ROSA DR		TELEPHONE:	(619) 550-4521
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY:	0	CENSUS: 0	DATE:	07/31/2024
		UNANNOUNCED	TIME BEGAN:	03:27 PM
MET WITH:			TIME COMPLETED:	03:43 PM

ALLEGATION(S):

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Lack of supervision resulted in resident elopement.

INVESTIGATION FINDINGS:

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LPA Kennedy concluded an investigation into the above allegation that was begun on 6/18/2021.

It was alleged that the resident 1 (R1) eloped from the facility due to negligence.

The investigation included interviews with internal and external sources a virtual tour of the facility and a review of documents.

The investigation revealed that on 6-12-21 R1 managed to dismantle the lock on the window that kept the window from opening fully. R1 placed pillows in their bed, climbed out the window shutting the window and blinds behind them and left the facility at about 10:30 PM.

Prior to R1’s elopement, R1 had said they would leave, however R1 regularly expressed intent to leave and staff did not find the statement remarkable.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

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-20210614145110

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SIENNA AT OTAY RANCH SENIOR LIVING	FACILITY NUMBER: 374604103
	VISIT DATE: 07/31/2024

NARRATIVE

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R1's wife was particularly concerned and called the facility to request R1 be checked on at about 11:30 PM. A staff member checked the room and saw the window and blinds closed and what appeared to be R1 in bed and reported that R1 was sleeping.

Care staff checked the room throughout the night and thought R1 was asleep in their room. R1 did not require personal care or other services in the night, so the care staff did not check closer.

When R1 was late to breakfast, a care staff member went to wake R1 up and found that the bed was full of pillows. The facility looked for R1 and soon called the police for assistance in locating R1.

While at the facility, R1 spent a lot of time in their room. R1 would retire to their room early and often would sleep for 12 hours at a time.

R1 was diagnosed with a condition making R1 appropriate to reside in a memory care unit, however R1 planned the elopement and had the forethought and the wherewithal to remove the lock and conceal their absence.

As the threat of elopement and the retirement to their room was not unusual, the facility had no reason to increase the supervision of R1.

Based on interviews and documentation, the preponderance of evidence has not been met to determine in R1’s elopement was the result of negligence. This allegation is Unsubstantiated.

A copy of this report, along with Licensee Rights (LIC 9058 01/16), were mailed via U.S. mail to the last mailing address on file.

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024

LIC9099 (FAS) - (06/04)

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