374604374-4-18-2024-08-AS-LTEZ-D4SUTH-20240429155157

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604374
Report Date: 04/18/2024
Date Signed: 04/18/2024 01:58:56 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
04/15/2024 and conducted by Evaluator Dawn Segura

COMPLAINT CONTROL NUMBER: 08-AS-20240415095144

FACILITY NAME:	A MISSION FOR MICHAEL		FACILITY NUMBER:	374604374
ADMINISTRATOR:	ROMANELLI, KEAN		FACILITY TYPE:	772
ADDRESS:	1155 HOOVER STREET		TELEPHONE:	(949) 371-3857
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	6	CENSUS: 5	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Anand Mehta, Executive Director		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff did not ensure that client received needed mental health services.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to conduct an investigation into the above listed complaint allegation. LPA was granted entry into the facility and met with Daniel Mendoza, Residential Supervisor, to whom she disclosed the reason for the visit. Anand Mehta, Executive Director, Kristian Concepcion, Clinical Director, Eric Schlothan, Clinical Director, and Brian Horansky, Program Manager, arrived a short time later.

It was alleged that a medication taken by Client 1 (C1) had recently been changed by C1’s psychiatrist, and C1 had concerns about the new medication. C1 asked staff about seeing C1’s psychiatrist; however, staff did not assist C1 to schedule an appointment or get in contact with the psychiatrist.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, review of facility records, and interviews with clients and staff.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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 08-AS-20240415095144

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: A MISSION FOR MICHAEL	FACILITY NUMBER: 374604374
	VISIT DATE: 04/18/2024

NARRATIVE

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The investigation revealed that clients who participate in the facility’s program are scheduled to have a visit with a physician once a week and a separate visit with a physician’s assistant once a week. During C1’s weekly meeting with the physician’s assistant, C1 had been prescribed a medication that he/she consented to. Subsequently, C1 decided that he/she did not want to take the medication because C1 determined that he/she did not have a need for the medication. Once the medication was prescribed, C1 did not take it and continued to refuse it on a daily basis. The physician’s assistant was made aware of C1’s continued refusals. C1’s following appointment was moved to an earlier date to address concerns about the medication refusal and treatment plan. Evidence indicates that, during these occurrences, C1 was continuously monitored by the facility’s staff, which includes nursing staff who communicate directly with the psychiatrist and physician’s assistant on the clients’ behalf. The investigation did not produce evidence to conclude that the client was not provided needed mental health services.

Based upon a review of records and interviews conducted, the above complaint allegation is unsubstantiated. This finding means that, although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted with Anand Mehta, Executive Director, and copies of this report and Licensee Rights (LIC 9058) were provided to the Executive Director at the conclusion of the visit. His signature on this report acknowledges receipt of copies of the rights and report.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

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