374604171-9-28-2022-08-AS-LTEZ-CJR4YM-20220929193120

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604171
Report Date: 09/28/2022
Date Signed: 09/28/2022 01:45:32 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
07/16/2020 and conducted by Evaluator Dawn Segura

COMPLAINT CONTROL NUMBER: 08-AS-20200716113029

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: 55	DATE:	09/28/2022
		UNANNOUNCED	TIME BEGAN:	11:13 AM
MET WITH:	Kandy Franklin, Executive Director		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility did not seek timely medical attention for a resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigative findings. LPA was granted entry into the facility and met with Kandy Franklin, Executive Director, to whom LPA disclosed the reason for the visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, review of facility and outside source records, and interviews of staff and outside sources.

It was reported to Community Care Licensing that Resident 1 (R1) [LIC 811 Confidential Names List was provided to identify the resident] fell out of his/her wheelchair in the facility, hit his/her head, and was found on the floor, but facility staff did not seek timely medical attention for R1.

Based upon information reviewed during the investigation, R1, who was a resident receiving hospice services,

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

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-20200716113029

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: 09/28/2022

NARRATIVE

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was found on the floor by facility staff on 5/14/2020 between 6:00 PM and 7:00 PM. Once found on the floor, R1 was assessed by staff for injuries, and the only injury noted was a red bump on R1’s forehead. According to interviews conducted, R1’s spouse was contacted at approximately 7:00 PM and informed that R1 had been found on the floor. Records indicate that, around the same time, the hospice agency which provided services to R1 was called and notified that R1 had been found on the floor. The hospice agency was informed by facility staff that it appeared that R1 had no injuries other than slight redness on the forehead, and facility staff declined a need for a nursing visit at the time. Records reflect that the hospice triage nurse encouraged staff to call the hospice agency with any other issues, concerns, or changes in R1’s condition, if any occurred.

Evidence reflects that, subsequently, at approximately 7:45 PM, facility staff called the hospice agency and advised that R1’s spouse requested a visit from the hospice nurse on the same night. A hospice nurse visited R1 at 8:19 PM on 5/14/2020 and noted that R1’s vital signs were within normal limits. It was also documented that the nurse was able to move all of R1’s extremities without difficulty, and there were no obvious signs of injury. It was noted that R1 had a red area in the mid forehead, and facility staff were advised to monitor R1 for any changes in level of alertness.

Based upon a lack of evidence yielded during the investigation to conclude that facility staff delayed for an extended period of time in contacting R1’s hospice agency and lack of evidence of any injury resulting from an alleged delay in R1 being seen by the hospice nurse, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Kandy Franklin, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided to the Executive Director at the conclusion of the visit. Kandy Franklin’s signature on this report acknowledges receipt of copies of the rights and report.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Dawn Segura	TELEPHONE: (619) 417-3928
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022

LIC9099 (FAS) - (06/04)

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