374604595-9-23-2024-08-AS-JROO-D9M732-20240930211736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604595
Report Date: 07/25/2024
Date Signed: 09/23/2024 04:12:35 PM

Unsubstantiated

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
06/21/2024 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20240621105233

FACILITY NAME:	HILLTOP HOME CARE CENTER		FACILITY NUMBER:	374604595
ADMINISTRATOR:	ANTONIO, JANE ARLYN H.		FACILITY TYPE:	735
ADDRESS:	110 ORANGE DRIVE		TELEPHONE:	(619) 777-3746
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91911
CAPACITY:	4	CENSUS: 3	DATE:	07/25/2024
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Caregiver Ruth Rabina and Administrator Jane Antonio		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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-Lack of staff supervision related to client incident.
-Licensee’s staff did not afford client choice over their activities.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced subsequent visit to deliver findings regarding the above prior complaint allegations. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Ruth Rabina. LPA also met with Administrator Jane Antonio, who arrived later during the visit.

The Complainant alleged that there was a lack of staff supervision related to an incident during which Client #1 (C1) sustained scratches on their face. They also alleged that Licensee’s staff did not afford C1 choice over their daily activities, because staff forced them to attend their offsite day program. CCLD’s investigation involved multiple unannounced facility tours/welfare checks and a collateral visit. The Department also interviewed all clients, pertinent facility staff, and multiple outside sources, and reviewed relevant care and personnel records.

[CONTINUED ON LIC 9099-C, 1 of 2]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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-20240621105233

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: HILLTOP HOME CARE CENTER	FACILITY NUMBER: 374604595
	VISIT DATE: 07/25/2024

NARRATIVE

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[CONTINUED FROM LIC 9099]

Interviews of outside sources and facility staff aligned to show that during the early morning of Monday 06-17-2024, multiple finger scratch marks were identified on C1’s face. The scratches were not bleeding and did not require first aid, but they looked fresh and reddened. Interviews of facility staff showed that these scratches were not present during the evening (PM) shift which ended around 10:00 PM on 06-16-2024 or the successive overnight (NOC) shift which ran from 10:00 PM on 06-16-2024 to 6:00 AM on 06-17-2024. Rather, these scratch marks were new and occurred sometime between 6:00 AM and 7:30 AM on 06-17-2024, during which time staff said C1 was by themselves either inside their private bedroom or inside the facility’s hallway bathroom.

Staff and outside source interviews aligned to show: When C1 was asked about how they got the scratches on their face, their explanations changed over time. C1 first said they scratched their face after falling into a bush. C1 later claimed that Client #2 (C2) scratched their face. By the time LPA interviewed C1 on 06-24-2024, C1’s facial scratches had fully healed, and C1 first told LPA that C2 caused the facial scratches. C1 later freely approached LPA to say they had earlier lied, and that they scratched their own face during the incident in question. [C2, meanwhile, was constant in the narrative they gave to outside sources, facility staff, and LPA; C2 consistently denied scratching C1 or having any physical altercation with them.] Multiple facility staff told LPA they suspected C1 engaged in self-scratching behavior on prior days. When LPA returned to the facility on 07-25-2024, C1 had new very light scratches on their abdomen. When LPA asked about these, C1 explained they scratched their own stomach with a Sharpie marker, and they would not tell LPA what motivated them to do it.

While Licensee’s staff did not know exactly how C1 obtained the scratches on their face (i.e., the ones discovered on 06-17-2024), the totality of evidence still did not support there being a lack of staff supervision of clients. C1’s latest LIC602 Physician’s Report, LIC9172 Functional Capability Assessment, and care documents from San Diego Regional Center (SDRC) together showed that C1 was ambulatory and largely independent in their personal care tasks. C1 needed staff reminders to shower, brush their teeth, and change their clothes, but was also physically self-capable in those areas. There was nothing to suggest that C1 needed 1-on-1 care or a level of supervision higher than what the facility normally provided.

[CONTINUED ON LIC 9099-C, 2 of 2]

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20240621105233

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: HILLTOP HOME CARE CENTER	FACILITY NUMBER: 374604595
	VISIT DATE: 07/25/2024

NARRATIVE

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[CONTINUED FROM LIC 9099-C, 1 of 2] Work schedules, corroborated by client and staff interviews, showed that a facility caregiver was continuously on the premises during the NOC shift that began on 06-16-2024 and during the AM shift that ended on 06-17-2024. In their interviews, both the NOC and AM caregivers denied seeing or hearing any clients arguing or fighting with each other. A review of two (2) months of Daily Client Notes evidenced satisfactory observation of clients. Several times per day, day after day, caregivers documented/charted each clients’ status, whereabouts, and/or behaviors in a log of handwritten notes.

Interviews of clients and staff further showed that while Licensee encouraged the clients to attend their assigned day program during the weekdays, no client was forced to go (nor punished if they did not go). LPA made unannounced visits to the facility on 06-24-2024 and 07-25-2024, spending several hours on-site each day. During each visit, C1 was present and relaxing at the facility. Partway during the second visit (i.e., on 07-25-2024), C1 told facility staff that they changed their mind and wanted to go to their day program. Staff escorted a gleeful C1 to the car to take them to day program. Based on observation of the clients’ interactions and demeanor with facility staff (to include S1) during his site visits, LPA had no concerns regarding Licensee’s staff honoring clients’ dignity and choice.

Based on records and interviews, a preponderance of evidence does not exist to show there was a lack of staff supervision during the incident where C1 had facial scratches, that Licensee’s staff yelled at a client, or that Licensee’s staff did not afford C1 choice over their daily activities. These two (2) allegations are therefore Unsubstantiated, and no deficiencies were cited for them.

An exit interview was conducted with Antonio, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

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