374604171-1-23-2024-08-AS-DPOL-CZYVGV-20240130152608

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604171
Report Date: 01/23/2024
Date Signed: 01/23/2024 04:36:16 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
12/22/2023 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20231222092615

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:	01/23/2024
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Jenna Purnell, Wellness Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not follow resident's care plan

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmesconducted an unannounced visit to deliver findings for the above-mentioned allegation. LPA identified herself and discussed the purpose of the visit with Jenna Purnell, Wellness Director.

On December. 22, 2023, Community Care Licensing (CCL) received a complaint alleging staff did did not follow resident's care plan. During the investigation, LPA Holmes collected pertinent resident records as well as facility documentation and conducted interviews. Interviews revealed that the resident has been livng at the facility since 08/01/2015. The care plans that were observed were completed on 12/12/2021 and again it was updated on 11/07/2023. Based on the two care plans observed, Resident 1(R1) did not have anything written or documented stating that they have a Do Not Resuscitate (DNR). Interviews with staff revealed R1 has no had a DNR on any of their care plans. Interviews with staff revealed they do not recall any documentation being provided to them from the family or from St. Pauls Pace. There is no information to corroborate the allegation. Based on LPA's interviews, and record reviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegation is unsubstantiated.

An exit interview was conducted with Jenna Purnell, Wellness Director , to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

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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