374604197-7-26-2021-08-AS-DPOL-C5FP3V-20210731105811

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604197
Report Date: 07/26/2021
Date Signed: 07/26/2021 01:36:04 PM

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
10/08/2020 and conducted by Evaluator Evangelica Torres

COMPLAINT CONTROL NUMBER: 08-AS-20201008090716

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: 116	DATE:	07/26/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator, Angela Kapiloff		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Licensee did not provide the appropriate supervision, resulting in Resident #1 eloping from the facility.
License not responding timely to their call alert signal, resulting in negligence in meeting Resident #1's care needs.
Licensee failed to follow the resident's incontinent plan.
Licensee failed to follow reporting requirements.

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 Administrator, Angela Kapiloff, and disclosed the purpose of the visit. The investigation included multiple interviews and review records.

It was alleged the licensee did not provide appropriate supervision for Resident #1's (R1) (See LIC 811- Confidential Names List for R1), resulting in them eloping from the facility. It was further alleged that the licensee did not respond promptly to R1's calls for assistance, resulting in not meeting R1's care needs, including their incontinency. In addition, it was also alleged that the licensee did not follow reporting requirements, as alleged incidents were not being reported within the required timeframe.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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-20201008090716

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: 07/26/2021

NARRATIVE

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On November 01, 2016, R1 was admitted to the facility. In reviewing R1's physician report dated September 18, 2019, the document stated that R1 is non-ambulatory and required assistance with their care needs. Though the report indicated that R1 could not leave the facility unassisted, the report also indicated that R1 did not have a cognitive impairment and history of wandering behavior. R1'a plan of care dated June 27, 2020, showed that R1 received hands-on assistance with bathing, stand-by support with dressing, and routine incontinent care. LPA also attempted to review the call alert logs for September 2020 through October 2020; however, those records could not be retrieved, as the facility no longer had the logs due to their system's limited memory space in retaining the information.

On or August 22, 2020, at approximately 06:30 PM, R1 informed the front desk receptionist that they would wait at the facility's front entrance for their responsible party to pick them up. Staff watched as R1 placed themselves at the front doors of the facility. Upon R1's responsible party's arrival, R1 was unable to be located. R1's responsible party asked the receptionist for R1's whereabouts. The receptionist replied that they last saw R1 waiting for them at the front entrance and thought they had already picked them up. The receptionist alerted the facility's administration, and all staff began to search for R1. As R1 was unable to be located within the facility's premises, 911 was called. At about 08:30 PM, the facility was informed that a good Samaritan found R1 at the church located next door to them. R1 was transported to the hospital for an evaluation. LPA reviewed the hospital records, and it showed that R1 arrived at the hospital at 09:06 PM. According to the hospital records, R1 sustained bruising and returned to the facility on August 23, 2020.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20201008090716

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: 07/26/2021

NARRATIVE

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LPA interviewed staff, and their interviews did not support either of the allegations, as their statements were consistent in that the resident was cognitively sound with no history of falls and, or wandering behavior, along with staff reporting incidents to the responsible party. LPA interviewed R1, and they denied all allegations, as they described themselves to be independent in making decisions and their care needs being met by staff, including their incontinent needs. R1 also indicated that they could not recall if all incidents were reported to them or their responsible party, as they have no concerns or complaints about the facility or its staff.

Based on interviews conducted and a review of documents, there is insufficient evidence to prove or disprove that the allegations occurred; therefore, the complaint investigation findings are found to be unsubstantiated.

An exit interview was conducted with the Executive Director. The Licensee/Appeal Rights (LIC 9058 01/16) and a copy of this report with signature was emailed to them. A return email or reply receipt from them will confirm receipt of documents

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Evangelica Torres	TELEPHONE: (619) 900-1407
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

LIC9099 (FAS) - (06/04)

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