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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604298
Report Date: 02/17/2022
Date Signed: 02/18/2022 04:17:26 PM

Unsubstantiated


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
10/27/2021 and conducted by Evaluator Anna Kennedy
COMPLAINT CONTROL NUMBER: 08-AS-20211027081158
FACILITY NAME:MACKENZIE CARE HOMEFACILITY NUMBER:
374604298
ADMINISTRATOR:PREECE, RAQUELFACILITY TYPE:
735
ADDRESS:2487 MACKENZIE CREEK RTELEPHONE:
(760) 460-1129
CITY:CHULA VISTASTATE: CAZIP CODE:
91914
CAPACITY:4CENSUS: 4DATE:
02/17/2022
UNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Raquel PreeceTIME COMPLETED:
04:47 PM
ALLEGATION(S):
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Resident not being provided medication as prescribed.
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INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kennedy conducted an unannounced complaint visit to deliver findings the above allegation. LPA identified herself and was invited in to the facility.
LPA met with Raquel Preece, Administrator and discussed the purpose of today's visit.

During the investigation LPA collected records, conducted interviews with internal and external sources and toured the facility.

It was alleged that the resident was not being provided medication as prescribed. This allegation was based on the conservator of Client 1 (C1) (See LIC 811 for confidential names) requesting the facility staff to give a medication that was prescribed to be given “as needed” to be given at the conservator’s request.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rebecca Hedgecock
LICENSING EVALUATOR NAME: Anna Kennedy
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
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 4
Control Number 08-AS-20211027081158
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: MACKENZIE CARE HOME
FACILITY NUMBER: 374604298
VISIT DATE: 02/17/2022
NARRATIVE
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A review of the documents revealed that C1 has the capacity to express their wants and needs including asking for help. The records also revealed that the medication was given to the client on multiple occasions. As C1 is capable of expressing their needs, and the medication was prescribed to be given as needed, the facility gave the medication as prescribed. This allegation is Unsubstantiated.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence that the alleged violation occurred.

This report was discussed with Raquel Preece, Administrator. A copy along with Licensee Rights (01/2016) was emailed to Ms. Preece at the conclusion of the visit. An electronic response confirms the receipt of these documents.
SUPERVISORS NAME: Rebecca Hedgecock
LICENSING EVALUATOR NAME: Anna Kennedy
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4