374604198-6-11-2020-08-AS-RHEK-BYPA4V-20210228225410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604198
Report Date: 06/11/2020
Date Signed: 06/11/2020 02:15:04 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
01/21/2020 and conducted by Evaluator Anna Kennedy

COMPLAINT CONTROL NUMBER: 08-AS-20200121081640

FACILITY NAME:	VISTA GARDENS		FACILITY NUMBER:	374604198
ADMINISTRATOR:	HUNDLEY, SHANNON		FACILITY TYPE:	740
ADDRESS:	1863 DEVON PLACE		TELEPHONE:	(760) 295-3900
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY:	99	CENSUS:	DATE:	06/11/2020
		UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Evelyn Delgado		TIME COMPLETED:	02:11 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff verbally abused resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Kennedy conducted a complaint visit via a video-calling app due to COVID-19 restrictions to deliver the findings for the above allegation. LPA identified herself and stated the purpose of the video-call to Evelyn Delgado, Associate Executive Director.
During the investigation, LPA toured the facility, reviewed records and conducted face to face and video call interviews.

It was alleged that a facility staff member verbally abused a resident by raising her voice to try to get the resident to stand to be showered. The investigation included interviews with a visitor who reported that they overheard the interaction. The visitor did not recall the date or the staff member and did not report their observations at the time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Anna Kennedy	TELEPHONE: (619) 997- 4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 08-AS-20200121081640

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: VISTA GARDENS	FACILITY NUMBER: 374604198
	VISIT DATE: 06/11/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Additionally, eight staff members including six direct care staff were interviewed. All of the staff members agreed that if a staff member treated a resident as reported it would have been a violation of their policy, and they would consider it verbal abuse. The caregivers interviewed reported being trained on being respectful to residents at all times and were unaware either by observation or report of any caregiver that was disrespectful to a resident. LPA reviewed facility policy and training documents regarding the dignity of residents and found it to be supportive of the individual right to be treated with dignity.

Although the events described may have happened, there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore, LPA determined the complaint investigations to be Unsubstantiated.

An exit interview was conducted with Evelyn Delgado, Associate Executive Director. Via video-call. A copy of this report along with Licensee Rights (LIC9058 01/2016) was provided to Ms. Delgado via email. An electronic response confirms the documents were received.

SUPERVISOR'S NAME: Rebecca Hedgecock	TELEPHONE: (619)767-2329
LICENSING EVALUATOR NAME: Anna Kennedy	TELEPHONE: (619) 997- 4108
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 2