374604198-2-21-2025-18-AS-JDHS-DE537R-20250221170023

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604198
Report Date: 01/31/2025
Date Signed: 02/21/2025 04:02:54 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/23/2023 and conducted by Evaluator Venus Mixson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230523123349

FACILITY NAME:	VISTA GARDENS		FACILITY NUMBER:	374604198
ADMINISTRATOR:	SANCHEZ, PAZ HILDA		FACILITY TYPE:	740
ADDRESS:	1863 DEVON PLACE		TELEPHONE:	(760) 295-3900
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY:	0	CENSUS: 0	DATE:	01/31/2025
		UNANNOUNCED	TIME BEGAN:	01:27 PM
MET WITH:	SENT US MAIL TO HILDA PAZ SANCHEZ, ADMINISTRATOR.		TIME COMPLETED:	01:28 PM

ALLEGATION(S):

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Staff did not provide access to a resident's records

INVESTIGATION FINDINGS:

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On February 14, 2025, Licensing Program Analyst (LPA), Venus Mixson, delivered the allegation findings for the investigation pertaining to the listed allegation, via US mail due to the facility being closed. During the investigation, LPA conducted staff and resident interviews, record reviews, and made observations.
On May 23, 2023, Community Care Licensing received a complaint alleging that staff did not provide access to resident’s records. It was reported that on January 31, 2023, Resident #1’s complete file was requested. The request was for records dated from January 1, 2021, to May 2023. It was advised that the facility sent documents, but the request was not complete. The file did not contain Resident’s Needs and Services Plan and/or current weekly progress notes.
Information obtained from interview with the previous Administrator, Hilda Paz, advised that the records were sent. Additionally, this Administrator stated that the facility sent over everything that was in Resident’s file. Administrator did not provide a date or proof that the documents were sent. Information obtained from interview with the current Administrator, Caroline Senteno, provided an email that indicated documents were sent to the requestor in June 2023, after the complaint was alleged. This poses a personal rights risk to residents in care.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus Mixson	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

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-20230523123349

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: VISTA GARDENS	FACILITY NUMBER: 374604198
	VISIT DATE: 01/31/2025

NARRATIVE

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Based upon the information obtained from interviews and record reviews, the allegation that staff did not provide access to a resident’s records is substantiated. The facility failed to provide the requestor requested documents in a reasonable amount of time.

The facility will be cited on Title 22 Regulations, Division 6, Chapter 08, Section 87468 Personal Rights.

An exit interview was conducted with Administrator, a copy of this report, 9099-D, and appeals rights were discussed and provided to the Administrator, Melody Parks.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus Mixson	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20230523123349

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: VISTA GARDENS	FACILITY NUMBER: 374604198
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/07/2025 Section Cited CCR 87468.1	1 2 3 4 5 6 7	Personal Rights of Residents in all Facilities. Residents in all residential care facilities for the elderly shall have all of the following personal rights...(9) To have communications to the licensee from their representatives answered promptly and appropriately.	1 2 3 4 5 6 7	FACILITY IS CLOSED
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: Staff did not provide access to a residents records until six months after the request was made. This poses a potential health and safety risk to the residents and clients in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Jazmond D Harris	TELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus Mixson	TELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC9099 (FAS) - (06/04)

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