374604533-9-14-2023-08-AS-LTEZ-CW5QEK-20230929120628

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604533
Report Date: 09/14/2023
Date Signed: 09/14/2023 05:37:33 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-20230807150425

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: 172	DATE:	09/14/2023
		UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Sam El Rabaa, Executive Director		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Staff left resident unsupervised for extended period
Facility gate was in disrepair

INVESTIGATION FINDINGS:

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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 left a resident unsupervised for extended periods, and a facility gate was in disrepair. The Department’s investigation consisted of two unannounced facility visits, review of pertinent records, interviews with facility staff, residents, outside sources, and LPA direct observations.

Regarding the allegation, "Staff left resident unsupervised for extended periods", it was alleged that a resident wandered away from the facility and was found in the parking lot. Staff interview revealed that the resident in question (R1) lived in the Assisted Living section of the facility and was independent outside of medication management. Interview with R1 revealed that they did not need staff assistance with bathing,dressing, Activities of Daily Living (ADLs), or incontinence care. (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: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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-20230807150425

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: 09/14/2023

NARRATIVE

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(Continued from LIC9099)

Interview with R1 revealed that they enjoy walking around the front and back of the facility and spend much of their time exercising. During a facility visit LPA directly observed R1 ambulating using their walker in the courtyard without issue. Records review revealed that R1 was independent and able to ambulate on their own without supervision around the facility. No evidence was found to prove that the Licensee was not meeting R1's supervision needs.

Regarding the second allegation, "Facility gate was in disrepair", it was alleged that an outside facility gate did not have a lock or handle, which resulted in a safety issue by allowing anyone to come and go from the facility. LPA direct observations of the gate in question revealed that the gate was located on the East side of the facility by the Assisted Living wing. LPA directly observed that a handle existed on the gate and was in good repair by physically testing it, and the gate could be opened without issue. Staff interview revealed that the Licensee was in the process of upgrading the gate to include a spring that allowed the gate to self-close, and a new handle that included an outward-facing lock for additional safety. Records review corroborated the staff statements regarding the repairs and showed the timeline of events for the upgrade. No evidence was found to prove that the Licensee allowed the facility gate to be in disrepair without taking action. Residents interviewed stated that the Maintenance Director is very timely with repairs, and addresses physical plant issues right away.

Based on interviews, direct LPA observations 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 Sam El Rabaa, Executive Director, 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: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC9099 (FAS) - (06/04)

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