374604254-1-30-2023-08-AS-DPOL-CNLVQ4-20230131153744

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604254
Report Date: 01/30/2023
Date Signed: 01/30/2023 12:33:18 PM

Unfounded

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
07/26/2021 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20210726113635

FACILITY NAME:	SILVERADO SENIOR LIVING-ENCINITAS		FACILITY NUMBER:	374604254
ADMINISTRATOR:	JOHNSON, MARIVEL		FACILITY TYPE:	740
ADDRESS:	335 SAXONY ROAD		TELEPHONE:	(949) 240-7200
CITY:	ENCINITAS	STATE: CA	ZIP CODE:	92024
CAPACITY:	122	CENSUS: 77	DATE:	01/30/2023
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:			TIME COMPLETED:	11:25 AM

ALLEGATION(S):

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Facility staff did not have residents participate in self-administering medication

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to deliver investigative findings. LPA was greeted by Administrator, Marivel Johnson to whom she identified herself and discussed the purpose of the visit.

The Department investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, multiple interviews with staff and outside sources, and records review.

On July 26, 2021, Community Care Licensing (CCL) received a complaint alleging that facility staff did not have residents participate in self-administering medication. It was specifically alleged that staff without proper credentials were crushing, mixing, and administering medication directly into the residents’ mouth without allowing the residents to participate in the process.

(continue on LIC9099C)

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2023

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-20210726113635

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: SILVERADO SENIOR LIVING-ENCINITAS	FACILITY NUMBER: 374604254
	VISIT DATE: 01/30/2023

NARRATIVE

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(Continue from LIC9099)

Review of the facility approved plan of operations, position job descriptions and staff training requirements indicated that staff designated to handle medication were required to complete the training required per Title 22 regulations. Review of records indicated the facility had written policies and procedures for the functions of the designated staff. A review of staff training records confirmed that the facility staff who assisted residents with the self-administration of medications met all of the initial training, testing and annual training requirements as specified in Health and Safety Code section 1569.69. Staff statements during interviews confirmed that they had taken all the required training and that as a condition of employment they were required to do annual trainings and testing in medication management. In addition, staff consistently stated they provided assistance to residents in memory care with self-administration as needed following specific orders authorized by the resident’s physician. Staff interviews consistently confirmed that they review and follow the resident’s physician’s orders as documented in the Electronic Medication Administration Record System, (EMARS). Staff indicated that in the EMARS system a resident’s record is highlighted with “crush medication and mix with (substance of choice based on resident’s preference)".

In addition, review of medication administration records during a facility visit conducted on July 30, 2021, confirmed there were no medication inconsistencies or errors during the period when this complaint was filed.

Based on the results of the investigation, which consisted of observations, interviews with key staff and outside sources, and review of pertinent resident and facility records there was no evidence found to support this allegation. The Department has found that the complaint allegation was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted with Administrator, Marivel Johnson, to whom a copy of this report, and Licensee Appeal Rights (9058 01/16) were provided at the conclusion of the visit.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2023

LIC9099 (FAS) - (06/04)

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