374604171-9-25-2023-08-AS-SJAB-CW4M8Y-20230928092351

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604171
Report Date: 09/25/2023
Date Signed: 09/25/2023 07:56:03 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
06/14/2023 and conducted by Evaluator Amy Domingo

COMPLAINT CONTROL NUMBER: 08-AS-20230614154953

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:	09/25/2023
		UNANNOUNCED	TIME BEGAN:	11:18 AM
MET WITH:	Jenna Purnell Wellness Director		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

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Staff hit resident
Facility staff did not safeguard residents belongings

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Domingo conducted a complaint investigation visit to deliver findings for the above allegation. LPA Domingo met with Wellness Coordinator Jenna Purnell.

The Department’s investigation consisted of record reviews, interviews with staff, and outside sources.

It was alleged that Resident 1 (R1) (See LIC811 list of confidential list of identification) was hit by staff. An outside source 1 (OS1) was interviewed and there has not been any reports by residents of staff hitting the residents. Outside Source 2 (OS2) was interviewed and there has been no observations of staff mistreating residents.

[Continued on LIC9099C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Amy Domingo	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

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-20230614154953

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: 09/25/2023

NARRATIVE

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[Continued from LIC9099]

Outside Source 3 (OS3) was interviewed and there has been no observations or reports of staff hitting any residents. R1 was interviewed and R1 reported that the staff have been respectful and has never hit R1, nor has R1 ever observed any other residents being hit or treated poorly. R1's Physician's Report confirmed that R1 is able to make decisions and does not have any cognitive deficits. R1 was observed to have no cognitive deficits which concurs with the Physician's Report. Resident 2 (R2) was interviewed and R2 had no concerns or complaints regarding staff. Resident 3 (R3) was interviewed and R3 stated that there were no complaints with staff.

It was alleged that the Facility staff did not safeguard residents belongings. LPA Domingo reviewed records and there is sufficient evidence that R1 had a list of belongings and the list coincided with R1's belongings. R2 records were reviewed and the resident belongings matched what R2 had in R2's room. R1 was observed with all of the listed items on the belongings list and R1 stated that there were no missing items. R3 records were reviewed and the belongings matched what R3 has in R3's room. Staff 1 (S1) was interviewed and was able to explain the policy and procedure of recording resident's belongings. Staff 2 (S2) was interviewed and S2 was able to explain the residents personal belongings list and how the list is updated as needed. Staff 3 (S3) was able to provide the facility policy of replacement of misplaced items.

The Department has investigated the allegations listed above. Based on evidence obtained, including interviews and records reviewed, the above allegations are determined to be unsubstantiated as the Department could not meet the preponderance of the evidence standard. An exit interview was conducted with Wellness Coordinator Jenna Purnell and a copy of this report and Licensee/Appeals Rights (LIC 9058 03/22) were provide.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Amy Domingo	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

LIC9099 (FAS) - (06/04)

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