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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604538
Report Date: 12/21/2023
Date Signed: 12/21/2023 10:16:38 AM

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
07/12/2023 and conducted by Evaluator Nacole Patterson
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20230712162633
FACILITY NAME:RANCHVIEW SENIOR ASSISTED LIVINGFACILITY NUMBER:
374604538
ADMINISTRATOR:SETTINERI, JEFFREYFACILITY TYPE:
740
ADDRESS:350 COLE RANCH ROADTELEPHONE:
(760) 717-4088
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY:42CENSUS: 22DATE:
12/21/2023
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Marketing Manager Maria FloresTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Neglect resulting in resident being severely malnourished
Neglect resulting in resident suffering dehydration
Neglect resulting in resident sustaining multiple pressure injuries
Neglect resulting in resident sustaining serious injury
Staff did not observe change in condition
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 Marketing Manager Maria Flores.

On 7/12/23 the following allegations were made against the Licensee regarding Resident 1 (R1): neglect resulting in resident being severely malnourished, neglect resulting in resident suffering dehydration, neglect resulting in resident sustaining multiple pressure injuries, neglect resulting in resident sustaining serious injury, staff did not observe change in condition. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, outside sources, and direct observations.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
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-20230712162633
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: 12/21/2023
NARRATIVE
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(Continued from LIC9099)

Regarding the allegation, "Neglect resulting in resident being severely malnourished", staff interview revealed consistent accounts of Resident 1 (R1) refusing to eat, often becoming agitated and spitting food out. Staff interview further revealed that the Licensee had ongoing contact with R1's doctor and responsible party regarding the lack of food intake, which resulted in adjustments that increased R1's nutrition intake. Outside source interview was consistent with staff interviews regarding R1's resistance and agitation with food and beverages. Outside source interviews did not express concern regarding the care being provided to R1 at the facility. Records review was consistent with staff interviews regarding R1's eating issues, revealing alternate prescribed interventions by R1's physicians to assist with nutrition and fluids. Interview attempts with R1 were unsuccessful.



Regarding the allegation, "Neglect resulting in resident suffering dehydration", staff interview revealed that in addition to meals, R1 also frequently refused offers to drink water and became agitated. The Licensee advised R1's doctor, and a plan was made to increase R1's liquid intake. Outside source interviews did not corroborate the allegation. Records review was consistent with staff interviews regarding R1's drinking challenges and gave evidence to the interventions prescribed by R1's physician to help with liquids intake. Interview attempts with R1 were unsuccessful.

Regarding the allegation, "Neglect resulting in resident sustaining multiple pressure injuries", staff interview revealed that R1 was not ambulatory and the Licensee was active in attempting to prevent pressure injuries by obtaining a special cushion for sitting, as well as a low air mattress bed. Staff interview further revealed that the Licensee took the appropriate steps to notify R1's medical professionals regarding pressure wounds that began to develop. Outside source interviews revealed that the pressure injuries sustained by R1 were not a result of the care being provided by the facility. Outside source interviews did not express concern regarding the care provided to R1 by the Licensee. Interview attempts with R1 were unsuccessful.

Regarding the allegation, "Neglect resulting in resident sustaining serious injury", staff interview revealed that the noted injuries sustained by R1 were due to multiple falls that occurred prior to their admittance to Ranchview Senior Assisted Living. Staff statements were corroborated with resident records.

(Continued on LIC9099-C)
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20230712162633
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: 12/21/2023
NARRATIVE
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(Continued from LIC9099-C)

Outside sources interviewed did not express concern regarding R1's care and treatment at the facility; outside sources informed that R1 sometimes forgot that they were non-ambulatory and attempted to walk. Interview attempts with R1 were unsuccessful.

Regarding the allegation, "Staff did not observe change in condition", staff interview revealed that staff checked on R1 every 1-2 hours due to being a fall risk. Staff interview further revealed that staff immediately contacted 911 and provided direct care to R1 after a fall at the facility. Records review corroborated staff statements and revealed that staff did observe R1's changes in condition and contacted R1's responsible party and physician timely. Interview attempts with R1 were unsuccessful.

Based on interviews, direct 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 Marketing Manager Maria Flores, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3