374604261-8-9-2023-08-AS-DPOL-CV5TNA-20230828145225

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604261
Report Date: 08/09/2023
Date Signed: 08/09/2023 11:57:18 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
05/22/2020 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20200522144321

FACILITY NAME:	AVANTGARDE SENIOR LIVING OF LA JOLLA		FACILITY NUMBER:	374604261
ADMINISTRATOR:	ESCOBAR, AGUSTIN		FACILITY TYPE:	740
ADDRESS:	6211 LA JOLLA HERMOSA AVE		TELEPHONE:	(818) 692-5284
CITY:	LA JOLLA	STATE: CA	ZIP CODE:	92037
CAPACITY:	45	CENSUS: 32	DATE:	08/09/2023
		UNANNOUNCED	TIME BEGAN:	11:21 AM
MET WITH:	Susan Caccam, Wellness Director		TIME COMPLETED:	11:47 AM

ALLEGATION(S):

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Staff failed to use safety measures to prevent spread of communicable disease
Staff did not notify resident’s authorized representative of resident’s illness
Facility does not have a director/administrator
Residents not provided with hygienic care items.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit to close out a complaint. LPA identified herself, was granted entry, and stated the purpose of the visit to Susan Caccam, Wellness Director During the investigation, LPA toured the facility, conducted interviews and conducted a records review.

It was alleged staff failed to use safety measures to prevent spread of communicable disease. Interviews revealed that the facility provided gloves, masks and gowns to all staff working at the facility. During the pandemic, if any of the residents were diagnosed with Covid they would have those same items outside of the resident's rooms. Interviews revealed that there was an overflow of items to use prior to going into the residents rooms. The facility would not let visitors in when they weren't allowed to have any to minimize the spread of covid. There was a case of shingles but no chicken pox. Interviews revealed the resident that had shingles was isolated in their room while the outbreak was active. There was not more than 3 cases that would have been treated as an outbreak and therefore did not need to be reported to CCL or to the County. Interviews did not reveal any evidence of staff failed to use safety measures to prevent spread of communicable disease

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

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-20200522144321

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: AVANTGARDE SENIOR LIVING OF LA JOLLA	FACILITY NUMBER: 374604261
	VISIT DATE: 08/09/2023

NARRATIVE

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It was alleged staff did not notify resident’s authorized representative of resident’s illness. Interviews revealed any time there was anything going on with a resident that needed to be reported would be. There was a lot more communication with responsible parties and conservators during the pandemic since there was not any visitors allowed. Interviews revealed the incidents that required elevation was reported and reported to the family. The incident where the resident had a case of Shingles this was reported to the residents family. Interviews did not reveal any evidence of staff did not notify resident’s authorized representative of resident’s illness.

It was alleged the facility does not have a director/administrator. Interviews revealed there has always been an administrator working although they have worked part time. Interviews with staff revealed there have been two administrators that both worked part time and came on different days. Interviews revealed that there has been a high turnover rate for the administrator position but it has been filled. Interviews did not reveal any evidence of the facility does not have a director/administrator

It was alleged residents not provided with hygienic care items. Interviews revealed there were plenty of hygienic items that were provided to the residents. The residents did not have to purchase deodorant, toothpaste and shampoo and conditioners. Interviews revealed that the facility purchased these supplies and provided them to the clients.
Interviews did not reveal any evidence of residents not provided with hygienic care items.

Based on the evidence obtained from the investigation, the above-mentioned allegations are unsubstantiated. An exit interview was conducted with Susan Caccam, Wellness Director and a copy of this report and Licensee Rights (LIC 9058 03/22) was provided at the end of the visit.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

LIC9099 (FAS) - (06/04)

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