374604538-7-21-2023-08-AS-LTEZ-CU9VJS-20230731162913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604538
Report Date: 07/21/2023
Date Signed: 07/21/2023 03:22:49 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
07/11/2023 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230711153142

FACILITY NAME:	RANCHVIEW SENIOR ASSISTED LIVING		FACILITY NUMBER:	374604538
ADMINISTRATOR:	SETTINERI, JEFFREY		FACILITY TYPE:	740
ADDRESS:	350 COLE RANCH ROAD		TELEPHONE:	(760) 717-4088
CITY:	ENCINITAS	STATE: CA	ZIP CODE:	92024
CAPACITY:	42	CENSUS: 24	DATE:	07/21/2023
		UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Maria Flores, Marketing Manager		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Lack of supervision resulted in resident injury.

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 Maria Flores, Marketing Manager.

On 7/11/23 it was alleged that facility staff's lack of supervision resulted in an injury to R1 (See LIC811 Confidential list of names) when they were pushed by another resident. The Department’s investigation consisted of two unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, outside sources, and LPA direct observations. Staff interviews revealed that staff presence was higher during the timeframe of the complaint due to an event. Interview revealed that an internal investigation was conducted by management regarding the incident and no staff observed any physical altercations between any residents on the day in question. Interviews revealed that R1 identified two different residents as the perpetrator, both of whom multiple staff and a private caregiver had a direct line of sight during the timeframe in question. (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: 07/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023

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-20230711153142

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: RANCHVIEW SENIOR ASSISTED LIVING	FACILITY NUMBER: 374604538
	VISIT DATE: 07/21/2023

NARRATIVE

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Continued from LIC9099

Resident interview revealed that R1 was not able to confirm the exact timeframe the event occurred, but the details of the incident and description of the alleged perpetrator remained consistent. R1 informed that they did not notify staff for help or make known that the event occurred until days later. Resident interview revealed that the incident was isolated and has not happened at any other time.

Outside source interview revealed that a private caregiver for an unrelated resident was present at every mealtime during the timeframe of the complaint, and no incidents were observed regarding any resident altercation. Outside source interview revealed that facility staff have been observed to be attentive and caring to residents' needs. No outside sources revealed concerns regarding staffing issues and/or lack of supervision during the timeframe of complaint.

Records review revealed that facility management conducted an internal investigation regarding the incident, which did not result in plausibility that the event could have occurred, or that lack of supervision existed during the timeframe of complaint.

During two unannounced facility visits, LPA directly observed the location of the incident in question. LPA observed that from almost all locations in the space, the alleged event would have been seen by the staff and/or private caregiver based on the noted locations of people in the room and the number of staff present during that time. LPA observed staff tending to residents and assisting them with Activities of Daily Living (ADLs) and group activities. LPA did not observe a situation where a resident was left unattended or in need of help without staff presence.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Maria Flores, Marketing Manager, 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: 07/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023

LIC9099 (FAS) - (06/04)

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