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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604171
Report Date: 08/30/2023
Date Signed: 08/30/2023 03:14:41 PM

Substantiated


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
07/25/2023 and conducted by Evaluator Iby Strong
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20230725121931
FACILITY NAME:LO-HAR SENIOR LIVINGFACILITY NUMBER:
374604171
ADMINISTRATOR:DUCHARME-FRANKLIN, KANDYFACILITY TYPE:
740
ADDRESS:768 DOROTHY STTELEPHONE:
(619) 444-8270
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:68CENSUS: 62DATE:
08/30/2023
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Wellness Director Jenna PurnellTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff handled resident in a rough manner
Staff spoke inappropriately to resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced complaint visit to deliver findings in the above-mentioned allegation. LPA met with Wellness Director Jenna Purnell, and Executive Director Jared Green and discussed the purpose of the visit.

On July 25, 2023, Community Care Licensing (CCL) received a complaint alleging staff handled resident in a rough manner and staff spoke inappropriately to resident.

During investigation, LPA Strong collected pertinent resident records as well as facility documentation and conducted interviews. According to allegation, on July 11, 2023, Resident 1 (R1) had an outburst that resulted in Staff 1 (S1) grabbing R1 by the wrists in a rough manner. Records collected revealed R1 is diagnosed with a major neurocognitive disorder and has a history of aggressive behavior. Interviews revealed that on the date of the incident, R1 had an emotional outburst and began yelling at staff and residents. Interviews also revealed that a witness present observed S1 grab R1 by each wrist and twisting them.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
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 08-AS-20230725121931
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: LO-HAR SENIOR LIVING
FACILITY NUMBER: 374604171
VISIT DATE: 08/30/2023
NARRATIVE
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A witness also revealed they observed S1 kick R1 in attempt to stop R1 from harming S1. Interview with staff who cared for R1 after the incident revealed that R1 was repeatedly stating their fear for S1 and reiterating the incident that had taken place. Interviews also revealed staff observing redness on R1’s wrist hours after incident.

Additionally, it was alleged that S1 used profanity against R1 during same incident on July 11, 2023. Interviews revealed that during the incident, witnesses heard S1 using curse words against R1 multiple times. Further interviews revealed that S1 has a history of using profanity during work hours.

Based on interviews, and records reviewed, a preponderance of evidence exists to support the allegations. Deficiencies are being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Wellness Director Jenna Purnell, and Executive Director Jared Green to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20230725121931
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: LO-HAR SENIOR LIVING
FACILITY NUMBER: 374604171
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/31/2023
Section Cited
CCR
87468.1(a)(3)
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Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(3)To be free from...abuse. This requirement was not met as evidenced by:
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Licensee agrees to terminate S1 and request agency staff not to return to facility.
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Based on interviews the licensee did not protect resident's personal right to be free from abuse in 1 of 57 persons in care ([R1]) which posed an immediate Safety risk to persons in care.
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Type B
09/13/2023
Section Cited
CCR
87468.1(a)(1)
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Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities...shall have all of the following personal rights:(1)to be accorded dignity in their personal relationships with staff. This requirement was not met as evidenced by:
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Licensee agrees to terminate S1 and request agency staff not to return to facility.
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Based on interviews the licensee did not accord resident dignity in their personal relationship with staff in 1 of 57 persons in care ([R1]) which posed a potential 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: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3