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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604411
Report Date: 11/22/2024
Date Signed: 11/22/2024 09:34:40 AM

Substantiated


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
03/08/2024 and conducted by Evaluator Ryan Fulton
COMPLAINT CONTROL NUMBER: 08-AS-20240308114025
FACILITY NAME:LA MAREA SENIOR LIVINGFACILITY NUMBER:
374604411
ADMINISTRATOR:DARYL ANN C ROBINSONFACILITY TYPE:
740
ADDRESS:5592 EL CAMINO REALTELEPHONE:
(442) 325-3510
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:125CENSUS: DATE:
11/22/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Executive Director Johnathan ThomasTIME COMPLETED:
09:40 AM
ALLEGATION(S):
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Staff did not respond to resident's call button in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Ryan Fulton and Arian Golbakhsh, along with Licensing Program Manager (LPM) Jennifer Lott, conducted an unannounced subsequent visit to deliver findings regarding the above allegation(s). LPAs/LPM were welcomed by, identified themselves to, and discussed the purpose of the visit with Executive Director Johnathan Thomas.

The Department's investigation consisted of LPA observations, interviews with facility staff, residents and outside sources as well as records reviews. It was alleged that on or about 02/03/2024, that staff did not respond to the resident's call button in a timely manner. Interviews conducted with staff revealed that all call pendant response times should not exceed ten minutes. Facility records revealed that during the timeframe of 01/22/2024 to 02/05/2024, the staff response times on 76 occasions, exceeded 20 minutes. Interviews and records revealed that most staff shortages took place during the early morning to mid-morning hours.
(Continued on LIC9099C)


Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) -76-2311
LICENSING EVALUATOR NAME: Ryan FultonTELEPHONE: 619-629-8938
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
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 3
Control Number 08-AS-20240308114025
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: LA MAREA SENIOR LIVING
FACILITY NUMBER: 374604411
VISIT DATE: 11/22/2024
NARRATIVE
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Outside source and resident interviews corroborated wait times in excess of 20 minutes even stating at times waiting up to 30 minutes for assistance.

The Department has investigated the complaint alleging staff did not respond to resident’s call button in a timely manner. Based on LPA’s review of facility files, staff and outside source interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiencies are cited per California Code of Regulations, Title 22, Division 6, on the attached LIC 9099-D.

An exit interview was conducted and a copy of this report, LIC 9099D, along with Licensee/Appeal Rights (LIC 9058 03/22) was reviewed/provided to Executive Director Johnathan Thomas at the end of the visit.

SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) -76-2311
LICENSING EVALUATOR NAME: Ryan FultonTELEPHONE: 619-629-8938
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20240308114025
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: LA MAREA SENIOR LIVING
FACILITY NUMBER: 374604411
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/22/2024
Section Cited
CCR
87411(a)
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PERSONNEL REQUIREMENTS – “…facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs…” This requirement is not met as evidenced by:
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Licensee will conduct inservice training with Staff in morning, after noon, and NOC shift and sign in sheets will be emailed to LPA on 12/13/2024.
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Based on LPAs interviews and record reviews, call button response times were in excess of 20 minutes on 76 different occasions during the period of 01/22/24 – 02/05/24. This poses a potential health and safety risk to 96 of 96 residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Jennifer LottTELEPHONE: (619) -76-2311
LICENSING EVALUATOR NAME: Ryan FultonTELEPHONE: 619-629-8938
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3