374604533-9-26-2023-08-AS-LTEZ-CW5TLU-20230929145007

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604533
Report Date: 09/26/2023
Date Signed: 09/26/2023 01:27:43 PM

Substantiated

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
05/25/2023 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230525132810

FACILITY NAME:	SANTIANNA OAKMONT SIGNATURE LIVING		FACILITY NUMBER:	374604533
ADMINISTRATOR:	THARP, CHRISTOPHER		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):

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Unlawful eviction.

INVESTIGATION FINDINGS:

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

On 5/25/23 it was alleged that the facility unlawfully evicted resident 1 (R1) due to ongoing disruptive behaviors by R1's visitor. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, and interviews with facility staff, residents, and outside sources.
Interview with the Executive Director (ED) confirmed that the eviction letter was sent to R1 and their responsible party on 5/1/2023, supported by two official letters of concern that were sent to R1 and their responsible party on 12/28/2022 and 3/31/23 regarding the disruptive behavior of R1's visitor. Interview with R1 and outside sources confirmed that R1 received the eviction notice.

(Continued on LIC9099-C)

Substantiated

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 3

Control Number 08-AS-20230525132810

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

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(Continued from LIC9099)

Records review further confirmed that the eviction letter was sent to R1 and their responsible party on 5/1/23, with the reason for eviction being the visitor's violation of the House Rules, a subsection of the Residence and Services Agreement. Additional staff and resident interviews corroborated the disruptive behaviors of R1’s visitor that was documented in both letters of concern and eviction notice.

Title 22 87224(a)(3) states the following: (a) The licensee may evict a resident for… (3) "Failure of the resident to comply with general policies of the facility". The regulation does not support eviction based on a non-resident's behavior, therefore the consequence of eviction due to R1's visitor's behavior is not valid.

Based on relevant interviews and records review, the preponderance of evidence has been met that the alleged violation occurred and is therefore substantiated. Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). A Plan of Correction was jointly developed with the Licensee. An exit interview was conducted with Executive Director Sam El-Rabaa, to whom a copy of this report, the LIC811 Confidential Names List, 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)

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Control Number 08-AS-20230525132810

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/26/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/26/2023 Section Cited CCR 87224(a)(3)	1 2 3 4 5 6 7	Eviction Procedures 87224(a) The licensee may evict a resident for one or more of the reasons listed in section 87224(a)(1) through (5)... (3) Failure of the resident to comply with general policies of the facility.	1 2 3 4 5 6 7	Licensee agreed to read and adhere to section 87224. Licensee agreed to not enforce the eviction notice that was sent to R1.
	8 9 10 11 12 13 14	This requirement is not met, evidenced by: Based on interviews and records review, the Licensee did not issue a lawful eviction notice to 1 of 171 residents (R1), which posed a Personal Rights Risk to residents 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: 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 appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC9099 (FAS) - (06/04)

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