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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604368
Report Date: 11/30/2022
Date Signed: 11/30/2022 01:18:12 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, 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
11/28/2022 and conducted by Evaluator Chinwe Nwogene
COMPLAINT CONTROL NUMBER: 18-AS-20221128161315
FACILITY NAME:MERAKEY - AMPAROFACILITY NUMBER:
374604368
ADMINISTRATOR:LYLES, BRITTANNYFACILITY TYPE:
737
ADDRESS:479 AMPARO DRIVETELEPHONE:
(442) 277-4554
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:4CENSUS: 4DATE:
11/30/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brittanny Lyles, Administrator
April Radovich, Facility RN		TIME COMPLETED:
01:25 PM
ALLEGATION(S):
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Staff mishandled a client's medication while in care.
INVESTIGATION FINDINGS:
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On November 30, 2022, Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced visit to investigate the above allegation. LPA met with Administrator, Brittanny Lyles, and Facility Nurse, April Radovich who was informed of the purpose of the visit. During the investigation, LPA interviewed staff, Resident's Responsible Party and Resident’s Endocrinology Nurse and reviewed Resident file.
Regarding the allegation “Staff mishandled a client's medication while in care”. It was alleged staff failed to give Resident insulin as prescribed. LPA interviewed Facility Nurse who stated the insulin is a 24hrs, long acting insulin that is administered at 6pm or before 7pm. Facility Nurse stated facility had an hour window to administer the insulin but due to resident behaviors the insulin wasn’t given to resident before resident was dropped off at parent’s house on 11/23/2022 at 6.30pm. However, Resident’s dad was notified before 7pm that insulin was not administered and Resident’s dad agreed to administer the medication immediately.

Continue on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
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 2
Control Number 18-AS-20221128161315
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: MERAKEY - AMPARO
FACILITY NUMBER: 374604368
VISIT DATE: 11/30/2022
NARRATIVE
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Continued from LIC9099

During LPA’s Interview with Resident’s responsible party, it was acknowledged that Resident’s dad was notified before 7pm that insulin has not been administered. LPA called Resident’s Endocrinologist and spoke to Endocrinology Nurse who confirmed the insulin is not time sensitive and can be given in an hour of the time prescribed.
Based on LPA interviews with staff, and Resident’s Endocrinology Nurse and review of residents file, there is not enough evidence to support the above allegation. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Brittanny Lyles.
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2