374604426-3-23-2023-08-AS-LTEZ-CQETA2-20230330143248

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604426
Report Date: 03/23/2023
Date Signed: 03/23/2023 12:46:48 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
11/22/2022 and conducted by Evaluator Rebecca A Ruiz

COMPLAINT CONTROL NUMBER: 08-AS-20221122144158

FACILITY NAME:	RIDGEVIEW ASSISTED LIVING COMMUNITY		FACILITY NUMBER:	374604426
ADMINISTRATOR:	DAYNES, ROBERT		FACILITY TYPE:	740
ADDRESS:	9825 GLEN CENTER DRIVE		TELEPHONE:	(858) 444-8560
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92131
CAPACITY:	68	CENSUS: 63	DATE:	03/23/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Administrator Robert Daynes		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Resident was not treated with dignity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint visit to conduct follow-up and deliver findings regarding the above-mentioned allegation. LPA identified herself to, was greeted by, and explained the purpose of the visit to Administrator Robert Daynes.

During today's visit, LPA conducted interviews with staff and residents.

The Department’s investigation consisted of interviews with staff, residents, and outside sources, review of records, and a tour of the facility. It was alleged that a resident was not treated with dignity. Interviews and records review revealed that in November 2022, Resident 1 (R1) stated that R1 was uncomfortable around a male staff and had woken up without clothing on several occasions. When asked for additional information, R1 could not recall any instances where any staff member had removed R1’s clothing and R1 did not report any soreness, redness, or discharge that would indicate any sexual trauma.
Continued on LIC9099-C page...

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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-20221122144158

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: RIDGEVIEW ASSISTED LIVING COMMUNITY	FACILITY NUMBER: 374604426
	VISIT DATE: 03/23/2023

NARRATIVE

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Interviews and a review of medical records revealed that R1 had a mild cognitive impairment, confusion, and short-term memory issues, used incontinence briefs, and required assistance with incontinence care, bathing, dressing, and grooming. Interviews revealed that R1 had a history of hallucinations and confusion regarding care provided at a previous facility. Interviews revealed that while R1 needed assistance with dressing, R1 could pull off easy to remove clothing and R1 had removed their clothing after waking up with soiled incontinence briefs on at least one occasion. Interviews and records review revealed that in November 2022, the facility self reported an incident report and report of suspected elder or dependent adult abuse to the Department regarding R1’s statements that R1 felt uncomfortable around a male staff. The report stated that the Administrator interviewed R1 multiple times and R1 was unable to recall the incident and did not voice any concerns at that time. Interviews revealed that the facility was unable to match R1’s description of the male staff member to a staff member working the overnight shift and the facility removed all male staff from R1’s care as a precautionary measure.

The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has not been met, therefore, this allegation is deemed unsubstantiated.

An exit interview was conducted with Administrator Robert Daynes and Assisted Living Director Lilian Escobar, to whom a copy of this report and the Licensee Appeal Rights (LIC9058 01/16) were provided via hard copy.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC9099 (FAS) - (06/04)

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