374604171-9-20-2023-08-AS-LTEZ-CW5Q8Q-20230929115709

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604171
Report Date: 09/20/2023
Date Signed: 09/20/2023 04:08:47 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/11/2023 and conducted by Evaluator Natasha Persaud

COMPLAINT CONTROL NUMBER: 08-AS-20230811100404

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:	09/20/2023
		UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Wellness Director, Jenna Purnell		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff was physically rough when assisting resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Natasha Persaud concluded the complaint investigation regarding the above mentioned allegation. LPA met with Wellness Director, Jenna Purnell.

During the investigation, records were reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged that staff were physically rough when assisting Resident #1 (R1). It was reported, a staff grabbed R1 harshly on 08/09/23 causing left side hip pain. R1’s Physician's Report dated 12/27/19 indicated R1 has paralysis on the left side of their body. R1’s Primary Care Nurse Physician reported R1 was a paraplegic that can feel from their left hip down but not from the left hip up. R1’s Primary Care Nurse’s Physician assessed R1 on 08/02/23 and 08/09/23 for hip pain and did not observe any injuries or trauma. Evidence obtained revealed R1 was wheelchair bound and leans to the left side of their wheelchair, which could cause friction or pain. Outside source interviews stated R1 has a history of fabricating stories. Staff interviews revealed R1 complained to facility staff on 08/15/23 that their outside source provider was rough while providing care. R1’s interview confirmed facility staff were not physically rough when assisting R1. Continued on an LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

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-20230811100404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: LO-HAR SENIOR LIVING	FACILITY NUMBER: 374604171
	VISIT DATE: 09/20/2023

NARRATIVE

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During the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation was deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Wellness Director, Jenna Purnell whose signature below confirms receipt of these rights.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

LIC9099 (FAS) - (06/04)

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