374604134-2-26-2025-08-AS-SJAB-DEBV7B-20250228151051

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604134
Report Date: 02/26/2025
Date Signed: 02/26/2025 01:02:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/30/2021 and conducted by Evaluator Carmen Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20210830151620

FACILITY NAME:	PACIFICA SENIOR LIVING VISTA		FACILITY NUMBER:	374604134
ADMINISTRATOR:	ENCISO, KAREN		FACILITY TYPE:	740
ADDRESS:	760 EAST BOBIER DRIVE		TELEPHONE:	(760) 946-6055
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY:	172	CENSUS: 76	DATE:	02/26/2025
		UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Angeles Frasier, Resident Service Coordinator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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- Facility did not allow resident to choose hospice service

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegation. LPA identified herself and was granted entry by concierge Terri Park. LPA stated the purpose of the visit and reviewed the findings of the complaint with Angeles Frasier, Resident Service Coordinator.

The Department’s investigation consisted of interviews with staff and outside sources, and records review of relevant documents pertinent to this investigation. On August 30, 2021, it was alleged that the facility denied resident from receiving hospice services of their choosing.

It was alleged the resident's #1 (R1) hospice agency was denied access to see the resident by facility staff when they arrived to provide R1 with their initial services. During the initial visit on September 1, 2021, LPA spoke with the now-former Executive Director (ED), Karen Enciso, who informed LPA the resident did not have a hospice order on file and needed to verify the information;

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

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-20210830151620

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: PACIFICA SENIOR LIVING VISTA	FACILITY NUMBER: 374604134
	VISIT DATE: 02/26/2025

NARRATIVE

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(Continuation of LIC9099)

they also needed to inquire with the resident’s direct power of attorney’s (DPOA) preference, which was verified. It was noted the former ED was aware the hospice services rendered to residents were the choice of residents and families. An interview with the Long-Term Care Ombudsman (LTCO) did not observe former issues annotated or have current concerns relating to residents' inability to receive services from their hospice agency or visitors. According to the license, the facility has a hospice waiver approved for 25. Upon review of the facility’s visitor log sheets dated August 19, 2021, through August 31, 2021, a registered nurse conducted their initial visit to R1 on August 27, 2021, and it was determined there were two additional visits conducted by the hospice agency for the remainder of the month, August 28th and 31st, 2021. According to the Communication Update log, the DPOA’s chosen hospice services admitted R1 into hospice for routine level of care during their initial visit, on August 27, 2021. Two additional visits were documenting the reason(s) for their visit which was routine care. According to R1 Physician’s Report (LIC 602), dated August 3, 2021, they were diagnosed with a cognitive impairment and were not under hospice care. A second LIC 602, dated August 27, 2021, said R1 was receiving hospice care. According to the hospice Staff Sign-In Sheet and the calendar for August 2021, the agency commenced services on August 27, 2021.

Based on the Department’s investigation of the above-mentioned allegation and the evidence obtained during staff and outside source interviews and records reviewed, there is insufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegation is deemed to be unsubstantiated.

The report was discussed, and an exit interview was conducted with Angeles Frasier, Resident Service Coordinator. A copy of this report along with Licensee/Appeal Rights (LIC9058 01/16) were provided to Resident Service Coordinator Frasier at the conclusion of the visit. The signature below confirms the documents were received.

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) 346-3976
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

LIC9099 (FAS) - (06/04)

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