405802297-3-30-2022-29-AS-KBUY-CDLN2V-20220418100523

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405802297
Report Date: 03/30/2022
Date Signed: 03/30/2022 11:29:33 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
03/25/2022 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20220325125812

FACILITY NAME:	OPTIONS - LEGATO HOME		FACILITY NUMBER:	405802297
ADMINISTRATOR:	DEBRA BERTRANDO		FACILITY TYPE:	735
ADDRESS:	3750 LA LUZ RD.		TELEPHONE:	(805) 464-4880
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY:	4	CENSUS: 4	DATE:	03/30/2022
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Thomas Bundren, Crisis Manager		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

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Facility is falsifying incident reports

INVESTIGATION FINDINGS:

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On 3/30/22 at 10:05 am, Licensing Program Analyst (LPA) Chavez conducted an unannounced 10-day complaint investigation. LPA met with Crisis Manager Thomas Bundren and explained the reason for the visit. Also present at this visit was Jeff Edler, Tri-Counties Regional Center Quality Assurance Specialist.
On the allegation “Facility is falsifying incident reports,” the complainant’s concern was that facility staff wrote incident reports for elopement and management changed the incident report to say independent time instead of elopement. To investigate the allegation, LPA interviewed the Administrator, Crisis Manager, and Crisis Staff, and reviewed facility records.

LPA interviewed the Crisis Manager on 3/30/22 at 10:05 am. Crisis Manager states that there have been no elopements in over a year and an incident report was sent to CCL. Crisis Manager says Residents #1 and #2 (R1 & R2) are the only residents who earn independent time. Manager states independent time is earned through good behavior and an assessment by the resident’s plan of care team.
Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Darlene Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

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-20220325125812

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: OPTIONS - LEGATO HOME	FACILITY NUMBER: 405802297
	VISIT DATE: 03/30/2022

NARRATIVE

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At 10:22 am on 3/30/22, LPA spoke with Administrator Debbie Bertrando. Administrator stated that they do not write incident reports for independent time, only for elopements. She states the last elopement was in March 2021 and this was reported to CCL.

On 3/30/22 at 10:25 am, LPA spoke with Crisis Supervisor Paola Morales. Ms. Morales states that there are only two residents with a tendency to elope and they have not eloped in over a year. She states that independent time is earned by R1 and R2, and explains that in independent time, staff drop off the resident at their place of choosing, and resident calls staff to pick them up. She states there have been no incidents of elopement during independent times.

On 3/30/22 at 8:20 am, LPA reviewed incident reports from January 2021 to present. There is one incident report for R1 from 3/29/21. There were no incident reports for independent time.

Based on the evidence obtained, the allegation “Facility is falsifying incident reports” is deemed Unsubstantiated. The facility does not report independent times for residents in incident reports to CCL which is valid, and elopements are being reported to CCL.

Exit interview conducted and report emailed to Administrator.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Darlene Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

LIC9099 (FAS) - (06/04)

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