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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604294
Report Date: 08/20/2024
Date Signed: 08/20/2024 11:21:25 AM

Substantiated


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
07/23/2024 and conducted by Evaluator Janette Romero
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240723150513
FACILITY NAME:LAS VILLAS DEL NORTEFACILITY NUMBER:
374604294
ADMINISTRATOR:FARISH, JOLENEFACILITY TYPE:
740
ADDRESS:1325 LAS VILLAS WAYTELEPHONE:
(760) 741-1047
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:198CENSUS: 187DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator, Jolene FarishTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff do not ensure facility is clean
INVESTIGATION FINDINGS:
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On 8/20/2024, Licensing Program Analysts (LPAs) Janette Romero and Debbie Palacios arrived unannounced to deliver findings regarding the above complaint. LPAs met with Administrator, Jolene Farish and Resident Care Director (RCD), Ana Ramirez who were informed of the purpose of the visit.

On 7/23/2024, it was alleged there is no housekeeping staff to clean the Memory Care Unit (MCU). On 7/31/2024, LPA Romero toured the facility, conducted interviews, and obtained copies of pertinent documentation. LPA Romero toured nine (9) resident bedrooms and bathrooms with Regional Director (RD), Nathan Condie and RCD Ramirez and observed six (6) of nine (9) resident bathrooms appeared to have feces stuck inside the toilet bowls, on the toilet seats, on the bathroom floor, and/or on the outside bedroom door handles. Three (3) of nine (9) resident bedrooms and bathrooms toured appeared to be in sanitary condition. LPA also observed feces on the floor in the shower near room 311.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette RomeroTELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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 5
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
07/23/2024 and conducted by Evaluator Janette Romero
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240723150513

FACILITY NAME:LAS VILLAS DEL NORTEFACILITY NUMBER:
374604294
ADMINISTRATOR:FARISH, JOLENEFACILITY TYPE:
740
ADDRESS:1325 LAS VILLAS WAYTELEPHONE:
(760) 741-1047
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:198CENSUS: 187DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator, Jolene FarishTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
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5
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9
Staff do not properly store food
INVESTIGATION FINDINGS:
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On 8/20/2024, Licensing Program Analysts (LPAs) Janette Romero and Debbie Palacios arrived unannounced to deliver findings regarding the above complaint. LPAs met with Administrator, Jolene Farish and Resident Care Director (RCD), Ana Ramirez who were informed of the purpose of the visit.

It was alleged residents get sick after eating food that is left out. LPA toured the kitchen with Administrator Farish and Chef, George “Lynn” Sharp. During tour of the kitchen, LPA observed food is stored according to Departmental regulations and the walk-in freezer is maintained at a temperature of 0 degrees Fahrenheit. The walk-in refrigerator had a temperature of 36 degrees F and food was stored in covered containers. LPA toured the dry food storage room and did not observe food stored in damaged containers. Only one (1) of nine (9) interviews conducted corroborated the allegation but were unable to identify any alleged victims.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette RomeroTELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 18-AS-20240723150513
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: LAS VILLAS DEL NORTE
FACILITY NUMBER: 374604294
VISIT DATE: 08/20/2024
NARRATIVE
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Eight (8) of nine (9) interviews conducted reported not having knowledge of residents getting sick after eating food that is left out. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to Administrator Farish.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette RomeroTELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 18-AS-20240723150513
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: LAS VILLAS DEL NORTE
FACILITY NUMBER: 374604294
VISIT DATE: 08/20/2024
NARRATIVE
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Administrator, Jolene Farish was interviewed and reported the facility had five (5) housekeepers and recently faced a housekeeping shortage due to one (1) housekeeper retiring, one (1) going on leave unexpectedly, and one (1) going on vacation for two (2) weeks. LPA reviewed the July 2024 staff schedule for the housekeepers, which indicates two (2) housekeepers were assigned to MCU on 7/31/2024.

On 7/31/2024, RCD Ramirez reported Staff 1 (S1) was assigned as the housekeeper for MCU that day. On 7/31/2024, LPA Romero was in the MCU from approximately 10:00 a.m. to 12:15 p.m and did not observe S1 or any other housekeeping staff cleaning the MCU. During LPA’s visit on 7/31/2024, RD Condie had S1 go to the MCU to begin cleaning the six (6) resident bedrooms/bathrooms toured identified to require cleaning. RD Condie reported the MCU would be thoroughly cleaned. Administrator Farish reported the facility has hired a new housekeeper and is in the process of filling the remaining vacancies. Based on LPA’s observations, interviews conducted, and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099 D. An exit interview was conducted, and a copy of this report was provided to Administrator Farish.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette RomeroTELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 18-AS-20240723150513
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: LAS VILLAS DEL NORTE
FACILITY NUMBER: 374604294
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2024
Section Cited
CCR
87470(a)(2)(A)
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(a) (2) (A) Surfaces such as floors, chairs, toilets, sinks, counters and tabletops shall be cleaned and disinfected on a regular basis to ensure they are safe and sanitary... This requirement was not met as evidenced by:
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Administrator Farish reported the facility has since hired two (2) new housekeepers and now has a total of 6 housekeeping staff to ensure the facility is maintained in sanitary condition. POC met.
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LPA observed 6 of 9 resident bedrooms/bathrooms toured appeared to have feces stuck inside the toilet bowls, on the toilet seats, on the bathroom floor, and/or on the outside bedroom door handles. This poses a potential health/safety/personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tricia DanielsonTELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette RomeroTELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5