374604606-2-9-2024-08-AS-JLOT-D2FTRG-20240214135728

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604606
Report Date: 02/09/2024
Date Signed: 02/09/2024 04:11:37 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
10/18/2023 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20231018134030

FACILITY NAME:	FAMILY COMFORT CARE		FACILITY NUMBER:	374604606
ADMINISTRATOR:	MORALES, BELLA AMOR D.		FACILITY TYPE:	740
ADDRESS:	2579 ARUNDEL AVE.		TELEPHONE:	(760) 814-3579
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92009
CAPACITY:	6	CENSUS: 5	DATE:	02/09/2024
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Administrator Bella Morales		TIME COMPLETED:	04:25 PM

ALLEGATION(S):

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Lack of supervision led to resident AWOL.

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 Administrator Bella Morales.

On 10/18/23 it was alleged that lack of supervision led to resident (R1) AWOL. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, outside sources, and LPA direct observations.

Staff interview revealed that during the timeframe of the incident, the Licensee had systems in place for resident safety and supervision such as frequent resident checks and alarmed doors. Staff interviews revealed that R1 did not have known history of exit-seeking behaviors or wandering at night.

(Continued on LIC9099 p.2)

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: 02/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024

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-20231018134030

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: FAMILY COMFORT CARE	FACILITY NUMBER: 374604606
	VISIT DATE: 02/09/2024

NARRATIVE

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(Continued from LIC9099 p.1)

Staff members interviewed consistently recited the procedures put in place for supervision and care of residents. Staff interview further revealed that R1's behavior was likely pre-meditated, as R1 had re-dressed themselves in the middle of the night, disarmed their bedroom alarm, and climbed over the backyard fence to exit the facility without staff knowledge.

Outside source interview revealed no concerns regarding the Licensee's care and supervision of R1. One outside source informed that the incident was a new behavior for R1, triggered by a visitation pattern disruption. A second outside source expressed no observations or concerns regarding resident supervision by the Licensee.

Records review revealed that R1 suffered from a cognitive impairment but was able to leave the facility without assistance. While records showed that R1 experienced confusion and disorientation, no records were found to show that R1 had a history of exit-seeking behaviors.

During an unannounced facility visit, LPA directly observed working, in-tact alarms on all exit doors at the facility, including in resident rooms.

Due to their baseline memory loss, R1 was unable to participate as a reliable historian/interviewee about the incident.

Based on interviews, direct LPA observations and records review, the investigation did not yield sufficient evidence to conclude that lack of supervision led to resident AWOL. Based upon the foregoing, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred." An exit interview was conducted with Administrator Bella Morales, 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: 02/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024

LIC9099 (FAS) - (06/04)

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