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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604552
Report Date: 05/07/2025
Date Signed: 05/07/2025 06:28:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
03/24/2025 and conducted by Evaluator Amy Rodgers
COMPLAINT CONTROL NUMBER: 08-AS-20250324131918
FACILITY NAME:ACORN OAKS MANOR IIFACILITY NUMBER:
374604552
ADMINISTRATOR:LIMPIN, ALEXANDERFACILITY TYPE:
740
ADDRESS:6217 ACORN STTELEPHONE:
(619) 777-9674
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:14CENSUS: DATE:
05/07/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Licensee/Administrator Alex LimpinTIME COMPLETED:
12:59 PM
ALLEGATION(S):
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9
Staff did not administer medication as prescribed
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Amy Rodgers made an unannounced visit to open an investigation on the above-mentioned allegation. LPA identified herself and disclosed the purpose of her visit with Licensee/Administrator Alex Limpin. On March 24th, 2025 , Community Care Licensing (CCL) received a complaint alleging that the Staff did not administer as-needed prescription medication (PRN) Oxycodone, as often as they should a couple of weeks ago. Records reveal Resident #1(R1) was a resident at the facility from 3/31/2023 to 4/28/2023. No records could be found for R1 in the timeframe the complainant states. Interviews with staff confirm they only give PRN per the physician's orders. Interview with R1's hospice care provider nurse recalls R1 and states they visited R1 at least every other day, if not every day, to ensure PRN's and prescribed medications were being given. The hospice nurse confirmed they did not have concerns and R1 was given all PRN and prescribed medication appropriately by the facility staff. Based on the information obtained during the investigation, it is determined that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the violation occurred, and it is therefore UNSUBSTANTIATED. An exit interview was conducted with the Licensee/Administrator Alex Limpin, to whom a copy of this report, and the Licensee Appeal Rights (LIC 9058 03/22) were provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2025
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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