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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405850480
Report Date: 05/22/2024
Date Signed: 05/23/2024 10:02:41 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
03/20/2023 and conducted by Evaluator Mark Jeffries
COMPLAINT CONTROL NUMBER: 29-AS-20230320095114
FACILITY NAME:OAKS AT PASO ROBLES, THEFACILITY NUMBER:
405850480
ADMINISTRATOR:CARL MEYERFACILITY TYPE:
740
ADDRESS:526 S RIVER ROADTELEPHONE:
(805) 239-5851
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:120CENSUS: 85DATE:
05/22/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Administrator, Carl MeyerTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff failed to observe resident’s nail care needs.
INVESTIGATION FINDINGS:
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 On 05/23/2024, at 8:30am, Licensing Program Analyst (LPA) Jeffries arrived unannounced to the facility to issue final findings to the allegation to this complaint. LPA also issue final findings on additional complaint and conducted initial investigation visit on a third complaint on this visit. LPA met with Administrator, Carl Meyer, announced who he is and the reason for the visit.
As to the allegation of, “Staff failed to observe resident’s nail care needs.” It was alleged that two residents were neglected to the point of having nail fugus. It was discovered through interviews, documentation and observation that on 03/23/2023, LPA conducted interview with Administrator, Administrator stated that the Podiatrist, Dr. Tisngson, DPM was at this facility today (03/23/2023) and was scheduled to treat two residents (R1 and R2). Administrator stated that R1 had a visit with the Podiatrist and R2 refused Podiatrist treatment on this visit. Administrator stated the Podiatrist routinely visit the facility monthly.

CONTINUED on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Mark JeffriesTELEPHONE: (805)562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
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 2
Control Number 29-AS-20230320095114
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: OAKS AT PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 05/22/2024
NARRATIVE
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On 03/23/2023, LPA attempted to interview R1 and R2. Both R1 and R2 could not answer basic cognitive screening questions. On 03/30/2023, LPA conducted a full review of R1 and R2’s medical files. R1 had a ‘Podiatric Evaluation and Treatment’ conducted by Dr. Tisngson, DPM, singed and dated on 03/23/2023. R2 had medical chart notes stating, “RSD (Podiatrist) tried to check residents’ toenail today, but resident refused….” Additionally, R2 had chart notes on 03/16/2023, that stated, “Resident went to see a Podiatrist today …” On 03/23/2023, LPA interviewed, Direct Care Staff 1-4 (S1, S2, S3, and S4). S1-4 all stated that R2 dose not respond to hygiene prompts, and refuses self-care help on a daily basis. Interviews of R3, R4, R5, and R6, all say that facility care staff do a good job at addressing any issues they have and feel safe and cared for in this facility. On 03/23/2023, LPA also viewed fire extinguishers throughout the facility to be in regulation compliance (87203), staffing to be in sufficient numbers and resident counsel meeting being conducted monthly with scheduled meeting posted on facility bulletin board. At this time there is not enough evidence to support the allegation of, “Staff failed to observe resident’s nail care needs.” and is unsubstantiated at this time.

Exit interview, report read, report singed, and report provided.

SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Mark JeffriesTELEPHONE: (805)562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC9099 (FAS) - (06/04)
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