374604407-3-28-2024-08-AS-SJAB-D3SUCD-20240328152745

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604407
Report Date: 03/28/2024
Date Signed: 03/28/2024 01:00:13 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
02/27/2024 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20240227150051

FACILITY NAME:	BAYSHIRE CARLSBAD		FACILITY NUMBER:	374604407
ADMINISTRATOR:	CHAD COLEMAN		FACILITY TYPE:	741
ADDRESS:	3140 EL CAMINO REAL		TELEPHONE:	(760) 720-9898
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	125	CENSUS: 119	DATE:	03/28/2024
		UNANNOUNCED	TIME BEGAN:	10:59 AM
MET WITH:	Pamela Talamantes		TIME COMPLETED:	11:54 AM

ALLEGATION(S):

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Facility staff forced resident to take a shower

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver findings on the above allegation. LPA met with Resident Services Director Pamela Talamantes and we discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegation. The investigation consisted of records review and interviews with facility staff and residents.

It was reported to CCL that facility staff forced Resident 1 (R1) to take a shower. [an LIC 811 Confidential Names List was provided to the facility representative to identify the resident.] Records review revealed R1 refused to shower three times on February 6, 2024. The facility attempted a "change of face" or had a different staff member ask R1 if R1 would like to shower but R1 refused again. Facility staff notified both R1's doctor and the Resident Services Director. R1 refused to shower twice on February 28, 2024 and on the third attempt R1 agreed to shower.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

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-20240227150051

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: BAYSHIRE CARLSBAD	FACILITY NUMBER: 374604407
	VISIT DATE: 03/28/2024

NARRATIVE

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Records review of R1's progress notes dated October 2023 through March 2024 revealed facility staff documented R1's daily status, including; complaints of pain or discomfort, safety checks, shower refusals, unwitnessed falls, etc.

LPA interviewed R1 at the facility. R1 stated that at first facility staff would ask R1 over and over if R1 wanted to shower whenever R1 refused to shower. R1 stated that now they only ask a few times whenever R1 refuses to shower. R1 further stated that staff have never forcefully made R1 shower or grabbed R1 by force to shower.

Interview with facility staff (FS) revealed all of the residents have a shower schedule. FS stated that if a resident refuses to shower they come back later and encourage the resident to take a shower. FS stated that R1 usually refuses to shower and also refuses to go to their doctors appointments. FS stated that R1 immediately says no to shower on R1's shower day and throughout the day various staff will try to encourage R1 to shower.

LPA interviewed facility staff II (FSII) who stated that if a resident refuses to shower they notify the doctor and discuss the importance of showering with the resident. FSII stated that staff will encourage the resident throughout the day to take a shower or a sponge bath if requested. FSII stated that R1 does not like to shower. FSII further stated that they have never heard of staff forcing R1 or any other resident to shower.

LPA interviewed outside agency (OA) who stated that they believe the staff at the facility are doing the best they can. OA stated that the facility offers to help R1 but R1 thinks they are "forcing" R1. OA stated that R1 also refuses to go to their outside agency appointments to see a specialist. OA stated that they do not believe that the facility staff are actually forcing R1 to shower but that is how R1 "feels".

The facility Resident Services Director (RSD) stated that community has attempted to care for R1 as best as they can and as much as R1 will allow them to. RSD stated that they do understand that a resident has a right to refuse ADLs, to include showers, however, they do have certain protocols that they implement when a resident refuses assistance with ADL’s. The facility will implement a change of face and a second or third attempt to assist the residents. As a result, a resident may see that protocol as the community being forceful. At no given time is a resident ever forced to take a shower or do something against their will.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20240227150051

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: BAYSHIRE CARLSBAD	FACILITY NUMBER: 374604407
	VISIT DATE: 03/28/2024

NARRATIVE

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Based upon the foregoing, the above listed allegation is unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegation is not valid.

An exit interview was conducted with Pamela Talamantes. A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Pamela Talamantes whose signature below verifies receipt of these rights.

SUPERVISOR'S NAME: Simon Jacob	TELEPHONE: (619) -76-2306
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024

LIC9099 (FAS) - (06/04)

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