405800142-8-18-2020-29-AS-KBUY-BSZQMV-20200831121810

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405800142
Report Date: 08/18/2020
Date Signed: 08/18/2020 04:35:33 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/29/2020 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20200729111403

FACILITY NAME:	CASA DE FLORES		FACILITY NUMBER:	405800142
ADMINISTRATOR:	CORINA SEGUNDO		FACILITY TYPE:	741
ADDRESS:	1405 TERESA DRIVE		TELEPHONE:	(805) 772-7372
CITY:	MORRO BAY	STATE: CA	ZIP CODE:	93442
CAPACITY:	120	CENSUS: 73	DATE:	08/18/2020
		UNANNOUNCED	TIME BEGAN:	03:49 PM
MET WITH:	Cornina Segundo		TIME COMPLETED:	04:12 PM

ALLEGATION(S):

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Facility staff are denying resident(s) access to their physician.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) De Leon has completed the investigation for the complaint allegation listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s delivery of final finding for the complaint allegation was conducted telephonically with Corina Segundo the facility Administrator. LPA explained the purpose of the telephonic visit to the Administrator.

On the allegation: Facility staff are denying resident(s) access to their physician, LPA De Leon conducted random interviews with 9 out of 74 residents (R1-R9) in care and all R1-R9's interviews revealed residents were able to make their own choice in physician's and the facility is offering residents several ways to visits with their physicians,Tele-Med

Continued 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2020

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 29-AS-20200729111403

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: CASA DE FLORES	FACILITY NUMBER: 405800142
	VISIT DATE: 08/18/2020

NARRATIVE

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appointments on IPAD’s with doctors and specialists, some of the physicians are making house calls into the facility for necessary medical visits and the facility is offering transportation to and from any medical appointments for residents. Interviews with Staff (S1, S2, S3) were conducted revealing the facility is helping all residents with all types of medical appointments from tele-med visits to in person visits and transportation is provided. S1, S2 and S3 have open communication with several different doctors, the facility purchased two IPAD’s for residents to use for visits, staff help set up the video IPAD’s and give residents privacy with their doctors and families, the doctor’s visiting the facility check in and out of the wellness department when seeing residents and Covid-19 procedures are followed. Based on the evidence in this investigation the allegation is deemed Unsubstantiated at this time.

A telephonic exit interview was conducted with Administrator, and a hard copy of report was provided via email for signature and return to Community Care Licensing.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 08/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2020

LIC9099 (FAS) - (06/04)

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