374604294-1-6-2023-18-AS-DMUN-CN6S7Y-20230117123818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604294
Report Date: 01/06/2023
Date Signed: 01/06/2023 11:15:41 AM

Unsubstantiated

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
07/12/2022 and conducted by Evaluator Tricia Danielson

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220712101108

FACILITY NAME:	LAS VILLAS DEL NORTE		FACILITY NUMBER:	374604294
ADMINISTRATOR:	FARISH, JOLENE		FACILITY TYPE:	740
ADDRESS:	1325 LAS VILLAS WAY		TELEPHONE:	(760) 741-1047
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92026
CAPACITY:	198	CENSUS: 174	DATE:	01/06/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Jolene Farish, Executive Director		TIME COMPLETED:	10:05 AM

ALLEGATION(S):

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Insufficient staffing to meet residents’ needs
Facility doesn’t have enough supplies
Facility did not provide adequate food service

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Tricia Danielson arrived unannounced to the facility to conclude an investigaton into the allegations listed above. LPA met with Executive Director Jolene Farish and explained the purpose of the visit. During today's visit, LPA interviewed one(1) staff.
Regarding the allegation "Insufficient staffing to meet resident's needs", it was alleged that the needs of residents in the memory care unit were not being met due to a lack of staffing due to a high turnover rate. Interviews conducted with six(6) memory care residents revealed three(3) of six(6) memory care residents reported their needs were met or exceeded by the staff in the memory care unit. Three(3) of six(6) memory care residents were unable to be qualified to be reliable witnesses. Interviews conducted with five(5) memory care staff revealed four(4) to five(5) staff are scheduled for each AM shift, three(3) to four(4) staff are scheduled for each PM shift, and two(2) to three(3) staff are scheduled for each NOC shift. Additionally, a med tech and a licensed vocational nurse is available for further supervision and assistance to residents during the AM and PM shifts. An activites person and the memory care director is also available for the AM shift and part of the PM shift. A med tech is available to memory care residents and assisted living residents during the NOC shift as well. Regarding the allegation "Facility doesn't have enough supplies", it was
(CONTINUED ON LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Tricia Danielson	TELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

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 18-AS-20220712101108

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: LAS VILLAS DEL NORTE	FACILITY NUMBER: 374604294
	VISIT DATE: 01/06/2023

NARRATIVE

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(CONTINUED FROM LIC9099)
alleged that the memory care unit has run out of food, soap, shampoo, and blankets several times. Interviews conducted with six(6) memory care residents revealed three(3) of six(6) memory care residents reported they have never been denied the use of food, soap, shampoo, or blankets at the facility due to lack of supply. Three(3) of six(6) memory care residents were unable to be qualified to be reliable witnesses. Interviews conducted with five(5) memory care staff revealed the memory care unit has not run out of supplies such as soap, shampoo, food, or blankets. During a tour of the memory care unit, LPA observed numerous staff interacting with residents, a stock of supplies of blankets, towels, washcloths, snacks, drinks, soap, shampoo, toothpaste, toothbrushes and personal grooming items. Regarding the allegation "Facility did not provide adequate food service", it was alleged that the memory care residents are usually served food that is expired. Interviews conducted with six(6) memory care residents revealed three(3) of six(6) memory care residents have never observed the food their were provided to be expired or spoiled. Three(3) of six(6) memory care residents were unable to be qualified to be reliable witnesses. Interviews conducted with five(5) memory care staff revealed the memory care unit has not served residents expired food however one(1) staff interviewed reported milk had twice arrived from the main kitchen spoiled during the summer and residents were not served the milk. During a tour of the memory care unit, LPA did not observe any expired or spoiled food or drinks.
Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

An exit interview was conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Tricia Danielson	TELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

LIC9099 (FAS) - (06/04)

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