405802288-4-12-2023-29-AS-KBUY-CRA4TJ-20230426192313

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405802288
Report Date: 04/12/2023
Date Signed: 04/12/2023 11:44:21 AM

Unsubstantiated

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
12/16/2021 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20211216125142

FACILITY NAME:	PARADISE VALLEY CARE		FACILITY NUMBER:	405802288
ADMINISTRATOR:	CAROLA WHITE		FACILITY TYPE:	740
ADDRESS:	9525 GALLINA CT		TELEPHONE:	(805) 468-4141
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY:	15	CENSUS: 6	DATE:	04/12/2023
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Carola White, Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Resident fell while in care
Staff working at facility under the influence of a substance

INVESTIGATION FINDINGS:

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On 4/12/23 at 11:25 am, Licensing Program Analyst (LPA) Darlene Chavez conducted an unannounced visit to the facility to deliver the final findings for the original complaint dated 12/16/21. LPA met with Carola White, Administrator, and explained the purpose of the visit.

On the allegation, “Resident fell while in care,” the complainant’s concern was that staff were under the influence of marijuana, and Resident #1 (R1) fell during a transfer by altered staff. Complainant states R1 was not injured during the incident. To investigate, LPA interviewed the administrator, staff, residents and witnesses.

On 11/17/22, LPA interviewed Carola White, Administrator. Administrator states that substances are not allowed and that there has “never been a problem in the workplace.” She says she has never seen staff unable to take care of residents and believes staff use an “appropriate transfer method.”

Continued on 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023

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 29-AS-20211216125142

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: PARADISE VALLEY CARE	FACILITY NUMBER: 405802288
	VISIT DATE: 04/12/2023

NARRATIVE

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At 12:38 pm, LPA spoke with Resident #2 (R2) who says of residing in the facility, “I like it.” R2 says “everybody’s busy, everyone has things to do, it’s like a family, people are helping each other, staff are very good.” R2 says they have no concerns with how staff are treating R2 and how staff behave. R2 relays that they have not seen any residents fall.

On 11/17/22, LPA spoke with Staff #1 (S1). S1 says they have no concerns about staff taking care of residents and has “Never seen any staff distracted or with hangovers or anything like that.” S1 says, “they are all very good.”

On 1/23/23, LPA interviewed Staff #2 (S2) and Staff #3 (S3). S2 explains that they were not on shift when R1 fell but says, “R1 went to hospital then rehab due to a possible hip fracture. I was told R1 was walking and then fell.” S3 says they were not present when R1 fell in 2021 but describes R1 as ambulatory with a walker before the fall and after the fall, “R1 walked perfectly fine with a walker and sometimes used a wheelchair.” S3 says they did not observe staff using marijuana and describes staff as “No one had a different type of demeanor.”

On 4/6/23, LPA interviewed Witness #1 (W1). W1 states that they were not aware of R1 falling in the facility in 2021. W1 says they were told about the fall but did not witness it. W1 says they never witnessed staff using marijuana and says the administrator, Carola, “Is really nice, cares about residents.”

Based on the evidence obtained, the allegation, “Resident fell while in care,” is deemed Unsubstantiated at this time. There is no evidence staff were altered and unable to provide services to residents in care.

On the allegation, “Staff working at facility under the influence of a substance,” the complainant was concerned that staff smoke marijuana outside of the facility and inside the facility bathroom and that the facility is poorly ran due to staff working while under the influence.

On 12/22/21, LPA interviewed Kara Freel-Sparks, Licensee/Administrator. Licensee states that staff “would have been fired, if they did something outside their job description.” Licensee says she does not recall ever dealing with an employee who was doing something outside their job duties while on shift and “we have never encountered an employee who was or appeared to be under the influence while at work.”

Continued on 9099-C.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20211216125142

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: PARADISE VALLEY CARE	FACILITY NUMBER: 405802288
	VISIT DATE: 04/12/2023

NARRATIVE

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On 11/17/22, LPA spoke with Carola White, Administrator. Administrator states that substances are not allowed in the workplace and “there has never been a problem.” She says there has never been a need to talk with staff regarding being intoxicated or high and that she has never seen staff unable to take care of residents. She says if she thought that was an issue, she would have staff do a drug test.

On 1/23/23, LPA spoke with S2 and S3. S2 says they have never observed staff smoking pot nor using any substances at the facility, neither indoors nor outdoors. However, they say they have noticed that “sometimes it smells like marijuana.” S3 says they don’t know who was smoking but that it “smelled like it outside near the front porch, coming from the neighbor’s house maybe.”

On 4/6/23, LPA interviewed W1. W1 says they have never witnessed staff using marijuana and says, “I would have identified it.” W1 states the staff do a great job.

Based on evidence obtained, the allegation, “Staff working at facility under the influence of a substance,” is deemed Unsubstantiated at this time.

Exit interview conducted and report given.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023

LIC9099 (FAS) - (06/04)

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