374604533-1-5-2023-08-AS-JRAE-CMTP4C-20230106095852

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604533
Report Date: 01/05/2023
Date Signed: 01/05/2023 01:21:44 PM

Unfounded

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
11/10/2022 and conducted by Evaluator Iby Strong

COMPLAINT CONTROL NUMBER: 08-AS-20221110142442

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: 134	DATE:	01/05/2023
		UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Executive Director Sam El-Rabaa		TIME COMPLETED:	11:25 AM

ALLEGATION(S):

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Facility has not conducted an emergency drill

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to collect records and to deliver findings on the above-mentioned allegation. LPA identified herself and discussed the purpose of the visit with Executive Director Sam El-Rabaa.

On November 10th, 2022, Community Care Licensing (CCL) received a complaint alleging facility has not conducted an emergency drill. During investigation, the Department collected pertinent facility documentation and conducted multiple interviews. According to interview with Executive Director, facility has conducted multiple emergency drills since accepting first resident on May 3rd, 2022. According to records collected, on April 23rd, 2022 and July 20th, 2022 there were emergency drills conducted for all staff. Additional records revealed that on August 17th, 2022 and December 7th, 2022 there was emergency preparedness training for staff and residents. Interview with staff revealed that there have been several emergency drills with staff since on or about April 2022.
Continue on LIC 9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Iby Strong	TELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023

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-20221110142442

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: SANTIANNA OAKMONT SIGNATURE LIVING	FACILITY NUMBER: 374604533
	VISIT DATE: 01/05/2023

NARRATIVE

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This agency has investigated the complaint alleging facility has not conducted an emergency drill. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened, and/or is without a reasonable basis. We have therefore dismissed the complaint. An exit interview was conducted with Executive Director Sam El-Rabaa, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Iby Strong	TELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2023

LIC9099 (FAS) - (06/04)

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