374604197-7-21-2021-08-AS-DPOL-C5FNQW-20210731104033

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604197
Report Date: 06/20/2021
Date Signed: 07/21/2021 08:35:11 AM

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
10/22/2020 and conducted by Evaluator Evangelica Torres

COMPLAINT CONTROL NUMBER: 08-AS-20201022152836

FACILITY NAME:	OAKMONT OF ESCONDIDO HILLS		FACILITY NUMBER:	374604197
ADMINISTRATOR:	DRESSLER, MELISSA		FACILITY TYPE:	740
ADDRESS:	3012 BEAR VALLEY PARKWAY		TELEPHONE:	(760) 735-8084
CITY:	ESCONDIDO HILLS	STATE: CA	ZIP CODE:	92025
CAPACITY:	160	CENSUS: 117	DATE:	06/20/2021
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Health Service Director, Anne Beauchamp		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Licensee did not meet Resident's needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Eva Torres conducted a visit to deliver findings on the above allegation. LPA identified herself, spoke with Health Service Director Anne Beauchamp, and disclosed the purpose of the visit. The investigation included multiple interviews and review records.

It was alleged the facility did not respond to Resident #1's (R1) (See LIC 811- Confidential Names List for R1) call alert in a timely manner.

On September 28, 2020, at approximately 03:10 PM, R1 pressed their emergency call alert button as they were not feeling well. As no staff responded to their call for assistance, R1 again pressed the emergency alert button. However, staff again failed to respond. Therefore, R1 called their responsible party to report they were not feeling well. R1's responsible party drove to the facility. Upon R1's responsible party's arrival to the facility, they shouted for assistance as they ran to R1's apartment. When R1's responsible party arrived at R1's apartment, two female nurses came behind them.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

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-20201022152836

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: OAKMONT OF ESCONDIDO HILLS	FACILITY NUMBER: 374604197
	VISIT DATE: 06/20/2021

NARRATIVE

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Staff assessed R1 and determined that R1's blood pressure was elevated. As a result, R1 was transported to the hospital for an evaluation and returned the same day.

LPA reviewed the facility's records, including the resident's records, the Emergency Response System policy, staff schedules, and the call alert system log for September 28, 2020. The review of R1's records showed that the R1 is independent in managing their care and supervision needs. In reviewing the facility's Emergency Response System policy, its states, "when the emergency signal is activated, it registers on the care provider's pager. The alert will provide the name of the resident and apartment number. When an alert is received on the pager, the care provider will note if the alert is coming from one of their assigned residents and respond to the alert. If the care provider cannot promptly answer the alert, the care provider will utilize their radio to request that another available care provider responds to the alert..."

Though staff's interviews were inconsistent with the review of its staff schedules and the call alert system log for September 28, 2020, the evidence showed that at 02:58 PM, the call alert in R1's bedroom announced itself nine (9) times, at which the report also stated that no staff responded to the alarm as of 03:43 PM. In reviewing the hospital emergency physician's notes dated September 28, 2020, the records also showed that R1 arrival at the hospital by ambulance was recorded at 03:59 PM and seen by emergency personnel at 04:08 PM.

In support, LPA interviewed R1 and found their interview consistent with the review of records and interviews conducted.

Based on interviews and the review of records, the preponderance of evidence standard has been met. Therefore, the above allegation is SUBSTANTIATED. California Code of Regulations (Title 22, Division 6), deficiency is cited on the attached LIC 9099D.

An exit interview was conducted, and Mrs. Beauchamp's signature was obtained on this report. The Licensee/Appeal Rights (LIC 9058 01/16) and a copy of this report was emailed. A return email or reply receipt from Mrs. Beauchamp will confirm receipt of documents. This is an amended version of the original report that was created on 06/20/21.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20201022152836

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: OAKMONT OF ESCONDIDO HILLS	FACILITY NUMBER: 374604197
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/20/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/09/2021 Section Cited CCR 87411(a)	1 2 3 4 5 6 7	Personnel Requirements: Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met as evidence by:	1 2 3 4 5 6 7	Mrs. Beauchamp informed the LPA that the facility has provided training to all staff on emergency response to included reviewing the call alert logs daily in order to identify areas of importance.
	8 9 10 11 12 13 14	Based on interviews conducted and records reviewed, the licensee did not adequately provide the service in meeting the emergency of R1’s needs. This posed a potential safety risk to one of 117 residents. This is an amended version of the original report that was created on 06/20/21.	8 9 10 11 12 13 14	Mrs. Beauchamp agreed to forward the staff training sign-in sheet and any updates that were made in improving staff response time to call alerts.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

LIC9099 (FAS) - (06/04)

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