374604176-1-12-2023-08-AS-SJAB-CNKQ9X-20230130105902

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604176
Report Date: 01/12/2023
Date Signed: 01/12/2023 03:09:54 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,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/18/2020 and conducted by Evaluator Denise Powell

COMPLAINT CONTROL NUMBER: 08-AS-20200918165220

FACILITY NAME:	ALTA VISTA SENIOR LIVING		FACILITY NUMBER:	374604176
ADMINISTRATOR:	ALSPACH, DAVID		FACILITY TYPE:	740
ADDRESS:	2041 W VISTA WAY		TELEPHONE:	(760) 941-3233
CITY:	VISTA	STATE: CA	ZIP CODE:	92083
CAPACITY:	98	CENSUS: 70	DATE:	01/12/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Monica Flores, Business Office Manager		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff inappropriately touched resident

INVESTIGATION FINDINGS:

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Licensing Program Manager (LPM) Denise Powell conducted an unannounced complaint visit to share investigative findings and close out the complaint. LPM was greeted and granted entry to the facility, then met with Business Office Manager Monica Flores and reviewed the complaint findings.

On 9/18/20, it was alleged that a direct care staff member touched a female resident in an inappropriate manner. The investigation included interviews with staff and outside sources and records review. Interview statements obtained from the resident did not provide valid disclosure. Interview statements by multiple facility staff and outside sources denied the allegation. Records review determined resident had documented change of condition and was under medical treatment for behavioral health concerns, including increased anxiety. There was insufficent evidence to support the allegation of staff inappropriately touching the resident. The allegation was determined as unsubstantiated since the preponderance of evidence standard was not met. LPM conducted an exit interview with Monica Flores and reviewed investigation findings. A copy of this report along with Licensee Rights was provided for facility records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-7269
LICENSING EVALUATOR NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023

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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