374604176-2-21-2025-18-AS-JDHS-DE9T8H-20250226133018

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604176
Report Date: 02/21/2025
Date Signed: 02/21/2025 01:39:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/17/2024 and conducted by Evaluator Armando Perez

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20241217105224

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: 82	DATE:	02/21/2025
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Business Office Manager Monica Flores		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Staff do not safeguard resident's personal belongings
Staff do not ensure resident’s room is free of tripping hazards

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Armando Perez, conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA met with Business Office Manager Monica Flores, where the LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of observations, interviews with staff members and residents, and a review of records.

On December 17, 2024, Community Care Licensing received a complaint alleging staff do not safeguard resident's personal belongings and staff do not ensure resident’s room is free of tripping hazards.

In regards to the allegation that staff do not safeguard resident’s poperty, it was reported that Resident #1’s (R1) room was being entered by R2 in the middle of the night. R2 would enter and take drinks and snacks from R1.
Continued on 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

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 18-AS-20241217105224

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ALTA VISTA SENIOR LIVING	FACILITY NUMBER: 374604176
	VISIT DATE: 02/21/2025

NARRATIVE

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Information obtained from interview with Administrator stated they were aware of R2 wondering the halls, but it was not reported R2 entered resident’s rooms and took their belongings. It was advised that due to the concern, the facility began to monitor R2 more closely and redirected R2 back to their room. Information obtained from additional staff interviews corroborated the information and stated there were no concerns advised regarding theft of R1’s belongings. Information obtained from Interview with R1 revealed they reported the concerns to their family, but could not remember if the concerns were relayed to facility staff. Information obtained from R2 did not corroborate the allegation. It was stated that R2 denied entering other residents room and taking their belongings. LPA conducted a record review and could not find any incidents regarding R2 entering rooms of other residents.

Pertaining to the allegation that staff do not ensure resident’s room is free of tripping hazards, it was reported that the facility had uneven floors in the living room, bathroom, and entrance of the resident rooms, which caused R1 to fall. Information obtained from interview with Administrator stated there were no issues with the floor being uneven or other hazards which caused falls. It was advised that the floor was updated due to wear and tear, but not because of foundational issues. Information obtained from staff interviews corroborated the information. Information obtained from interview with R1 indicated that they did not observe uneven floors or have issues with the flooring. Additional interviews were conducted and there were no concerns advised regarding the facility. During a visit to the facility, LPA observed eight rooms, including the noted areas of concern and R1’s room. LPA did not observe any abnormalities on the floors that would be considered uneven or hazardous. Pertinent documentation was reviewed and although there were falls reported, they were not due to hazards.

Based on observation, record review, client, and staff interviews, the allegations that the facility did not safeguard resident’s personal belongings and staff do not ensure resident’s room is free of tripping hazards, are Unsubstantiated. A finding that the complaint is unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted where a copy of this report was provided to Business Office Manager Monica Flores.

SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

LIC9099 (FAS) - (06/04)

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