374604171-8-30-2023-08-AS-SJAB-CV8VNJ-20230831163512

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604171
Report Date: 08/30/2023
Date Signed: 08/30/2023 04:54:41 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
08/28/2023 and conducted by Evaluator Iby Strong

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230828141929

FACILITY NAME:	LO-HAR SENIOR LIVING		FACILITY NUMBER:	374604171
ADMINISTRATOR:	DUCHARME-FRANKLIN, KANDY		FACILITY TYPE:	740
ADDRESS:	768 DOROTHY ST		TELEPHONE:	(619) 444-8270
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92019
CAPACITY:	68	CENSUS: 62	DATE:	08/30/2023
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Wellness Director Jenna Purnell		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Physical Abuse

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to open a complaint investigation on the above complaint allegation. LPA identified herself and discussed the purpose of the visit with Wellness Director Jenna Purnell.

On August 28, 2023, Community Care Licensing (CCL) received a complaint alleging Resident 1 (R1) was physically abused by an unknown source.

During today’s visit, LPA Strong conducted interviews, and reviewed facility records. According to allegations, on August 11, 2023, R1 was sleeping in the living room of their cottage when an unknown person hit R1.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Iby Strong	TELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023

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-20230828141929

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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According to R1’s Physician Report signed July 13, 2023, R1 can leave facility unassisted and can communicate needs. Additionally, R1 records collected revealed that R1 has had recent increases of agitation towards staff and roommates. Interview with R1 established that R1 believes they were hit on the head in the middle of the night by an unknown source. R1 states there were no people present in the cottage at the time of the incident. Interview with staff present on the date of the incident established that R1 did not report such abuse to staff working. Interview with another staff member revealed that resident stated to them that R1 was suddenly hit with what appeared to be an idea in the middle of the night but was not indicated that R1 was physically hit by an unknown source. Interview with residents did not corroborate that there was an incident in the cottage on the date mentioned.

Based on LPA's interviews, and record reviews there is not a preponderance of evidence to prove alleged violations occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with Wellness Director Jenna Purnell and Executive Director Jared Green, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Iby Strong	TELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023

LIC9099 (FAS) - (06/04)

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