374604579-3-20-2025-08-AS-SJAB-DF7TH6-20250328144413

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604579
Report Date: 03/20/2025
Date Signed: 03/20/2025 01:29:18 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
07/16/2024 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20240716102004

FACILITY NAME:	HEALING ADULT GROUP CARE INC.		FACILITY NUMBER:	374604579
ADMINISTRATOR:	SAIF, SALLY		FACILITY TYPE:	735
ADDRESS:	3919 EL CANTO DR.		TELEPHONE:	(248) 307-6966
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY:	6	CENSUS: 4	DATE:	03/20/2025
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Sally Saif, Administrator		TIME COMPLETED:	01:37 PM

ALLEGATION(S):

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Staff are mismanaging residents medications
Staff are not following Physician's orders

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit to close out the complaint investigation. LPA introduced herself, was granted entry, and met with Sally Saif, Administrator, to whom she disclosed the reason for the visit.

LPA conducted interviews and obtained and reviewed pertinent records. It was alleged staff are mismanaging residents medications. Interviews revealed that Staff 1 (S1) gives medications according to doctors orders. S1 revealed that if any medication is Discontinued (DC'd) that they no longer will give the medications. Interveiws revealed that Client 1 (C1)'s family wanted S1 to discontinue a medication and S1 informed them that they could not DC the medication just because they were telling them too. Interviews revealed that C1 takes medications in the mornings before program, in the afternoon when they arrive from program, evenings at dinner time and bedtime medications. S1 or any staff that is working will usually give C1 their medications. Interviews revealed that in March, April and May that C1 was taking Omeprazole for GERD, Folic acid as a supplement and Acidophilus a priobiotic according to C1s quartely report, Medications list and Medication Administration Report (MAR). Interviews and document review revealed according to the June, July and August quarterly report, Omeprazole and Folic acid were discontinued and were no longer given to C1. Interviews with outside sources revealed that they are not in the house 24/7 with (C1) so they cannot attest to the accuracy of staff administration of medications. However, the outside source stated that It is their responsibility to report anything of concern if they see otherwise. Interviews revealed that at each appointment, they review all medications. Interviews revealed that the pharmacy provides bubble wrapped medications which provide specific dose times. The pharmacy should only dispense medications to the facility for the clients that are up to date.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

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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Control Number 08-AS-20240716102004

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: HEALING ADULT GROUP CARE INC.	FACILITY NUMBER: 374604579
	VISIT DATE: 03/20/2025

NARRATIVE

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It was alleged that staff are not following Physician's orders. Interviews with outside sources revealed that at some time, C1s medications were changed when C1 was seeing another doctor. Interviews revealed that C1 was not taking medications that were supposed to be discontinued (DC) at that time. Outside source revealed that they have went over the medication list with the pharmacy and saw no discrepancies. Interviews revealed that C1 is very stable right now and the family wants to take them off certain medications but does not realize C1 is stable due to being on those medications and that if they take C1 off those medications they will not be doing as well as they are now. Interviews revealed that any restrictions that were initially imposed back in 2021, S1 was not aware of due to client not living at the facility at that time. Interviews revealed that C1 had dietary restrictions stating no dairy, no acidic foods or carbonated beverages, this was shown on MARS dated 5/21/2024-06/19/2024 and MARS dated 07/20/2024- 08/18/2024.

The Department has investigated the above-mentioned allegations and based on interviews with staff, clients and outside sources, the preponderance of the evidence has not been met, therefore, this allegation is deemed unsubstantiated.

An exit interview was conducted with Administrator, Sally Saif, to whom a copy of this report, LIC 811 Confidential Name List, and the Licensee Appeal Rights (LIC9058 03/22), were provided at the conclusion of the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025

LIC9099 (FAS) - (06/04)

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