374604315-9-20-2024-18-AS-TDAN-D9GPEX-20240926111550

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604315
Report Date: 09/20/2024
Date Signed: 09/20/2024 11:54:44 AM

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
12/14/2022 and conducted by Evaluator Janira Arreola

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20221214152829

FACILITY NAME:	CARING HEARTS COTTAGE		FACILITY NUMBER:	374604315
ADMINISTRATOR:	LAZARUS, AARON		FACILITY TYPE:	740
ADDRESS:	682 VALE VIEW DR		TELEPHONE:	(619) 246-0731
CITY:	VISTA	STATE: CA	ZIP CODE:	92081
CAPACITY:	8	CENSUS: 5	DATE:	09/20/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Staff, Robert Luna		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Staff handled resident in a rough manner
Staff do not assist resident with ambulating
Staff do not assist resident with bathing
Staff do not assist resident with grooming
Staff spoke inappropriately to resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Janira Arreola, conducted an unannounced visit to the facility in order to investigate the above allegations. LPA met with Staff, Robert Luna, who was informed of the purpose of the visit. The investigation consisted of LPA conducted interviews, documented observations, and conducted records reviews.

It was alleged that “Staff handled resident in a rough manner”, it was alleged that Staff had handled the resident by “shoving” Resident #1 (R1) into the shower and “forcing” R1 onto the toilet. LPA conducted interview with resident who did not recall the incident and denied staff handled R1 roughly. LPA conducted interviews (2) staff who denied R1 was handled in a rough manner. Staff revealed R1 required a (2) to (3) person assist when toileting, but denied witnessing or shoving R1 in the shower or toilet. Therefore, the allegation is unsubstantial.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

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-20221214152829

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: CARING HEARTS COTTAGE	FACILITY NUMBER: 374604315
	VISIT DATE: 09/20/2024

NARRATIVE

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It was alleged that “Staff do not assist resident with ambulating”. It was alleged that staff did not assist R1 with their therapist ordered exercises. It was alleged that on 12/11/2022, R1 had not been assisted out of bed, and that R1 had stated staff keep them on the couch or in bed all day. It was also alleged that Staff had remarked that “they do not pay her enough to break her back”. LPA conducted resident interview which revealed that R1 would be in bed or on the couch, and stated at times they did not want to get up and walk due to pain. LPA conducted (2) staff interviews which revealed R1 was offered to get up and walk, however at times R1 denied this and stated they were in pain. Staff reported R1 would be transferred with a Hoyer lift and placed on the couch or toilet. Staff interviewed denied saying or having knowledge of staff making statements about not being paid enough to break their back. Therefore, the allegation is unsubstantiated at this time.

It was alleged that “Staff do not assist resident with bathing” It was alleged that on 12/11/2022 R1’s hands were observed to be “dirty” and was not provided with a bathe. LPA conducted interview with resident who was unable to recall a time when they did not get bathed or cleaned between bathes. LPA conducted interviews with (2) staff who were unable to recall a time when R1 had dirty hands and were not cleaned. Staff revealed R1 was bathed by staff (2) times a week on Monday and Thursday. LPA conducted visit on 12/16/2022 and did not observed R1 had dirty hands. Therefore, the allegation is unsubstantiated.

It was alleged that “Staff do not assist resident with grooming” It was alleged that on 12/11/2022 R1’s nails were long and dirty and staff did not assist R1. LPA conducted interview with resident who was unable to recall a time when they did not get assistance with cutting their finger nails. LPA conducted interviews with (2) staff who were unable to recall a time when R1 had dirty hands and were not cut. Staff revealed R1 was assisted with grooming, unless they refused to be helped by staff. LPA conducted visit on 12/16/2022 and did not observed R1 had dirty hands. Therefore, the allegation is unsubstantiated.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20221214152829

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: CARING HEARTS COTTAGE	FACILITY NUMBER: 374604315
	VISIT DATE: 09/20/2024

NARRATIVE

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It was alleged that “Staff spoke inappropriately to resident”. It was alleged that Staff had told R1 they had no rights. There was no staff name given pertaining to the allegation or date. LPA conducted interviews with resident who was unable to recall an incident where staff told them they have no rights. LPA conducted (2) staff who denied saying or hearing a staff tell R1 they had no rights. Therefore the allegation is unsubstantiated at this time.

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 allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janira Arreola	TELEPHONE: 951-233-6759
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024

LIC9099 (FAS) - (06/04)

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