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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604274
Report Date: 03/21/2024
Date Signed: 03/21/2024 12:15:19 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
02/26/2024 and conducted by Evaluator Sara Martinez
COMPLAINT CONTROL NUMBER: 18-AS-20240226114855
FACILITY NAME:VISTA DEL LAGO MEMORY CAREFACILITY NUMBER:
374604274
ADMINISTRATOR:MARIE HILLFACILITY TYPE:
740
ADDRESS:1817 AVENIDA DEL DIABLOTELEPHONE:
(760) 741-2888
CITY:ESCONDIDOSTATE: CAZIP CODE:
92029
CAPACITY:96CENSUS: 93DATE:
03/21/2024
UNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH:Executive Director Marie HillTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Resident was sexually assaulted while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sara Martinez made an unannounced visit to the facility to deliver findings for the allegation noted above. LPA was granted entry and met with Executive Director Marie Hill and discussed the details pertaining to the complaint.

Regarding the allegation “Resident was sexually assaulted while in care”, it was reported an unknown individual entered Resident One’s (R1) room and attempted to abuse and hurt R1. Interview with LVN Alicia Anderson revealed the unknown individual is a resident, Resident Two (R2). On 02/23/2024, R1 was calling for help to assist R1’s roommate when R2 entered their room without R1’s consent and sat on R1’s bed. R1 yelled at R2 to get out of their room and R2 did not leave the room. R2 stated they wanted a kiss and R2 gestured with their hands to perform a sexual act. R1 began to push R2 out of their room with R1’s walker. Staff One (S1) arrived at R1’s room to assist with re-directing R2 back to their own room. S1 noted no injuries from the interaction for both residents. R1 stated R2 never touched or sexually assaulted R1 during the interaction. Record review of R2’s Needs and Service Plan revealed R2 has behaviors of exhibiting inappropriate sexual behaviors.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
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 18-AS-20240226114855
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: VISTA DEL LAGO MEMORY CARE
FACILITY NUMBER: 374604274
VISIT DATE: 03/21/2024
NARRATIVE
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LPA inquired about R2’s previous inappropriate sexual behaviors with Resident Service Director Priscilla Bermudes and it was revealed R2 is verbally inappropriate and will make sexually inappropriate statements to staff and residents. Bermudes stated R2 has never touched or harmed a resident.

Therefore, based on interviews and record review, there was not enough information to corroborate the alleged allegation, the allegation “Resident was sexually assaulted while in care” has been deemed unsubstantiated at this time. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted where a copy of this report was discussed and provided to Executive Director Hill.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Sara Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2