374604455-2-2-2024-08-AS-IESA-D2X5BV-20240229184924

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604455
Report Date: 02/02/2024
Date Signed: 02/02/2024 03:31:50 PM

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
10/11/2021 and conducted by Evaluator Becky Kennedy

COMPLAINT CONTROL NUMBER: 08-AS-20211011082146

FACILITY NAME:	IVY PARK AT OTAY RANCH		FACILITY NUMBER:	374604455
ADMINISTRATOR:	WILLIAMS, REBECCA		FACILITY TYPE:	740
ADDRESS:	1290 SANTA ROSE DRIVE		TELEPHONE:	(619) 779-7400
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY:	137	CENSUS: 104	DATE:	02/02/2024
		UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Silvia Garcia		TIME COMPLETED:	03:42 PM

ALLEGATION(S):

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Staffing is not sufficient to meet resident's needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst Becky Kennedy concluded the investigatioSilvia Garcia, Business office Manager. LPA advised her of the reason for today's visit and delivered the investigation findings on the above allegation.

The investigation into the above allegations consisted of interviews with internal sources, a review of internal and external documents, and a tour of the facility.

It was alleged that the facility’s staffing is not sufficient to meet resident's needs.

The investigation revealed that when a resident pushed their call alert button often a staff member responded in less than five minutes, however it was not uncommon for call alerts to be answered in more than 20 minutes, 30 minutes, to over an hour.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

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-20211011082146

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: IVY PARK AT OTAY RANCH	FACILITY NUMBER: 374604455
	VISIT DATE: 02/02/2024

NARRATIVE

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A review of documents revealed that in a single 7-day period it took 20 minutes or longer to answer 136 of the 1024 call alerts throughout the facility. For the week analyzed, 13.3% of the alerts took 20 minutes or longer to answer.

Interviews revealed that facility staffing had declined specifically the number of care staff working at any given time. As a result, residents wait longer to receive care. This situation was ongoing and potentially affected all resident that required care.

On one identified occasion Resident 1 (R1) (A list of confidential names was provided to the facility) pushed their call alert button. When no staff arrived to assist R1, an outside source became aware and attempted to contact staff members on behalf of R1. When no staff member could be reached by telephone, the outside source dialed 911. Documents revealed that facility staff did not respond to call alert for 45 minutes. The local emergency agency responded and found R1 required basic care that facility care staff then provided. The care was only provided after the emergency staff responded to the facility.

Based on the evidence obtained during the complaint investigation, the allegation that the facility is not adequately staffed to meet resident’s needs is SUBSTANTIATED, meaning that there is a preponderance of the evidence proving that the alleged violation occurred.

An exit interview was conducted with Silvia Garcia, Business Office Manager; a copy of this report and Licensee's Rights (LIC9058) were provided.

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20211011082146

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: IVY PARK AT OTAY RANCH	FACILITY NUMBER: 374604455
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/02/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/09/2024 Section Cited CCR 87411(a)	1 2 3 4 5 6 7	Personnel Requirements Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs…	1 2 3 4 5 6 7	Facility hired more full time staff and part time staff to cover as any vacancies. Policy of call report review daily was initiated.
	8 9 10 11 12 13 14	Based on interviews and review of records the licensee did not have personnel sufficient in numbers…to provide the services necessary to meet the needs 104 of the 104 persons in care which posed a potential risk to the health and safety of persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2024

LIC9099 (FAS) - (06/04)

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