374604533-9-26-2023-08-AS-LTEZ-CW5THH-20230929144446

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604533
Report Date: 09/26/2023
Date Signed: 09/26/2023 01:29:20 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
08/07/2023 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230807090556

FACILITY NAME:	SANTIANNA OAKMONT SIGNATURE LIVING		FACILITY NUMBER:	374604533
ADMINISTRATOR:	EL RABAA, SAM		FACILITY TYPE:	740
ADDRESS:	2560 FARADAY AVE		TELEPHONE:	(442) 325-8090
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92010
CAPACITY:	226	CENSUS: 171	DATE:	09/26/2023
		UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Sam El-Rabaa, Executive Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not ensure a family council was generated for a resident
Staff denied an authorized representative access to the facility

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced visit to deliver findings regarding the above complaint allegations. LPA introduced herself and disclosed the purpose of the visit to Sam El-Rabaa, Executive Director.

On 8/7/23 it was alleged that staff did not ensure a family council was generated for a resident, and staff denied an authorized representative access to the facility. The Department’s investigation consisted of three unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, and outside sources.

Regarding the allegation, "Staff did not ensure a family council was generated for a resident", it was alleged that the Licensee did not assist with the creation of a Family Council upon request. Staff members interviewed denied receiving notice that a Family Council had been formed, in order to provide the required assistance. (Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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 4

Control Number 08-AS-20230807090556

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SANTIANNA OAKMONT SIGNATURE LIVING	FACILITY NUMBER: 374604533
	VISIT DATE: 09/26/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

(Continued from LIC9099)
Staff members interviewed denied that a request for a liaison, meeting space, or flyer space had been made. Resident interview revealed knowledge that a Family Council was attempted to be created by a family member, but no resident had knowledge that the Licensee was made aware of the attempt. Resident interview revealed that a Family Council did not exist at the time of the complaint. Residents interviewed stated they did not see a need for a Family Council and/or did not want to participate in one. Review of facility and outside source records confirmed that the Licensee did provide information regarding Family Councils both in the Residency Agreement and during the onboarding process. Records review did not corroborate that the Licensee had knowledge of the formation of a Family council, or that the Licensee denied meeting space, a liaison, or space to display information for an existing Family Council. A preponderance of evidence was not found to support that the Licensee prohibited the formation of a Family Council. Records review showed that it is the Licensee's responsibility to provide meeting space, a liaison, and space to display information if a Family Council has been formed; it is not the responsibility of Licensee to create a Family Council.

Regarding the allegation, "Staff denied an authorized representative access to the facility", it was alleged that an Outside Individual (OI) was not allowed visitation with resident 1 (R1) on facility property. Staff interview revealed that OI was not denied private access to R1, including off property visitation and for medical appointments. Staff interview revealed that due to ongoing disruptive and concerning behaviors by OI, which violated the Residence and Services Agreement and personal rights of other residents, OI was asked to leave the property on multiple occasions, and eventually denied access to visits on facility property. Staff interview corroborated the disruptive and concerning behaviors and incidents involving OI. Resident interview also corroborated the disruptive and concerning behaviors involving OI, residents stating that they avoid OI when OI is at the facility. 3rd party and resident interview revealed that the Licensee agreed for OI to visit directly in R1’s room, but the arrangement was declined by OI. Based on evidence obtained through interview and records, the Licensee’s decision to restrict OI's access to the facility was based on documented disruptive incidents witnessed by both staff and residents. The confirmed behaviors infringed upon the personal rights of other residents to be accorded safe, healthful and comfortable accommodations, which the Licensee is responsible for providing. The evidence does not support that the Licensee restricted all forms of OI’s visitation to R1.

Based on interviews and records review, a preponderance of evidence does not exist to prove that the alleged violation(s) occurred, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with Executive Director Sam El-Rabaa, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
08/07/2023 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230807090556

FACILITY NAME:	SANTIANNA OAKMONT SIGNATURE LIVING		FACILITY NUMBER:	374604533
ADMINISTRATOR:	EL RABAA, SAM		FACILITY TYPE:	740
ADDRESS:	2560 FARADAY AVE		TELEPHONE:	(442) 325-8090
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92010
CAPACITY:	226	CENSUS: 171	DATE:	09/26/2023
		UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Executive Director Sam El-Rabaa		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not meet the minimum qualifications required

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced subsequent visit to deliver findings regarding the above prior complaint allegation. LPA met with and discussed the purpose of the visit with Executive Director Sam El-Rabaa. On 8/7/23 it was alleged that "Staff did not meet the minimum qualifications required", specifically that the Executive Director (ED) did not meet the minimum qualifications for his position. CCLD’s investigation involved unannounced facility visits, staff interviews, and records review. Staff interview revealed that ED had an equivalent experience letter on file, which was approved by the Department on 4/15/2020. Records review confirmed that the required documentation was submitted and approved by CCLD regarding ED's equivalent education and experience. Based on records and interviews, the allegation that staff did not meet the minimum qualifications required is UNFOUNDED, meaning it was false, could not have happened, and/or is without a reasonable basis. The allegation has therefore been dismissed. An exit interview was conducted with Executive Director Sam El-Rabaa, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

Unfounded

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 4