421703341-9-11-2020-29-AS-KBUY-BUDNMQ-20201014103532

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 421703341
Report Date: 09/11/2020
Date Signed: 09/11/2020 03:57:06 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
04/23/2020 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20200423161002

FACILITY NAME:	PITA BOARD AND CARE		FACILITY NUMBER:	421703341
ADMINISTRATOR:	CHRISTINA PITA		FACILITY TYPE:	740
ADDRESS:	259 MOONCREST		TELEPHONE:	(805) 934-2649
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	6	CENSUS: 3	DATE:	09/11/2020
		UNANNOUNCED	TIME BEGAN:	03:29 PM
MET WITH:	Gloria Pita, Licensee		TIME COMPLETED:	03:43 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff is mishandling resident’s personal funds

Staff is not administering medication as prescribed

Staff is making unauthorized decisions without proper consent

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 9/11/2020 at 3:29 pm, Licensing Program Analyst (LPA) Chavez conducted a final-findings visit for a complaint on the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint meeting was conducted telephonically. The LPA met through video chat with Gloria Pita, Licensee, and explained the purpose of the visit.

On the allegation “Staff is mishandling resident’s personal funds”, the complainant’s concern was that the licensee and a Friend #1 (F1) of the Resident #1 (R1) had taken too much control of R1’s life. The complainant stated that R1 had a tendency to accept whatever sounded good when R1 heard it. The complainant was concerned that R1’s friend had closed R1’s joint bank account with R1’s Power of Attorney (POA) and opened a new joint account with F1 and R1, and that F1 had taken control of R1’s account. To investigate this allegation, the LPA interviewed the complainant, the resident, the facility licensee, and the POA; and reviewed contractual agreements.

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: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

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 4

Control Number 29-AS-20200423161002

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE. SUITE 200
GOLETA, CA 93117

FACILITY NAME: PITA BOARD AND CARE	FACILITY NUMBER: 421703341
	VISIT DATE: 09/11/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On 4/29/2020 at 4:13 pm, the LPA interviewed R1 who stated that R1 closed a bank account that R1 had with R1’s Power of Attorney and opened a new account with R1 as the sole account owner. R1 states that although F1 and the licensee help with banking, R1 is the only person on R1’s bank accounts and R1 makes R1’s own money decisions.

F1 is not associated with the facility and this case is outside of CCLD’s jurisdiction.

The complainant was concerned about the licensee having control over R1’s money. The LPA reviewed the admission agreement between R1 and Pita Board and Care, and within it, the Record of Client’s/Resident’s Safeguarded Cash Resources (LIC 406) does not show any entries of monetary transactions or any other type of asset listing. On the form, the licensee writes: “We don’t handle money or cash at the facility.” On 4/27/2020 at 4:22 pm, the LPA interviewed the licensee who stated that she did not open a banking account with R1. The licensee stated she assists R1 with paying bills, however, licensee stated she does not handle or manage R1’s monies.

On 6/17/2020, the administrator stated in a meeting with the licensee, POA, and the LPA that she recently asked R1 if R1 would be okay with adding the POA back to R1’s bank account. The administrator said her purpose for asking was tied to a conversation she had with R1’s POA this week where the POA stressed the strong desire to get back on to R1’s account so the POA could manage R1’s bills. R1’s response was “No.”

Based on this investigation, the LPA did not find sufficient evidence to support that R1’s funds were mishandled by staff. As a result, regarding the allegation that, “Staff is mishandling resident’s personal funds”, the finding is Unsubstantiated at this time.

On the allegation “Staff is not administering medication as prescribed”, the complainant’s concern was that the licensee was not continuing Resident #1’s (R1) regimen of medications which included psychotropic medicine “that seemed effective for R1.” To investigate this allegation, Licensing Program Analyst (LPA) Chavez interviewed the complainant, the resident, the licensee, administrator, and the POA; and reviewed R1’s medical records, prescriptions, Centrally Stored Medication Sheets, and Medication Administration Record (MARs).

Continued on 9099-C

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) -59-343
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: 805-450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20200423161002

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE. SUITE 200
GOLETA, CA 93117

FACILITY NAME: PITA BOARD AND CARE	FACILITY NUMBER: 421703341
	VISIT DATE: 09/11/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The LPA spoke with the complainant to confirm what psychotropic medications R1 was taking prior to going to the Veterans’ Administration (VA) and which “seemed effective.” The complainant stated R1 was taking Lithium Carbonate 300mg, Aripiprazole 5mg, and Lamotrigine 150mg, prescribed by R1’s primary Psychiatrist #1 (P1).

LPA reviewed R1’s prescriptions, Centrally Stored Medication Sheets, and Medication Administration Record (MARs) dated 6/1/2019 through 5/1/2020. Although R1 began seeing doctors at the VA, R1’s secondary Psychiatrist #2 (P2) at the VA prescribed the same psychotropic medications with the same dosages as P1 had prescribed. There was not a lapse in time where R1 received the psychotropic medications, and there had been no changes in psychotropic medications R1 had taken prior to going to the VA.

Based on this investigation, the LPA did not find sufficient evidence to support that R1 is not receiving medication as prescribed. As a result, regarding the allegation that, “Staff is not administering medication as prescribed”, the finding is Unsubstantiated at this time.

As to the allegation “Staff is making unauthorized decisions without proper consent”, the complainant showed concern that Resident #1 (R1) was advised to discontinue R1's services with the Veterans Administration (VA) doctors. There was concern that the licensee and R1’s Friend #1 (F1) were acting with no regard for the authority R1’s Power of Attorney (POA) had. To investigate this allegation, Licensing Program Analyst (LPA) Chavez interviewed the complainant, the resident, the facility licensee, and the facility administrator; and reviewed legal documents, admission agreement, and medical documentation.

Regarding the complainant’s concerns about F1 making unauthorized decisions without proper consent as it relates to R1, CCLD cannot enforce regulations on individuals who are not affiliated with the facility.

The POA states that R1 was seeing a Psychiatrist #1 (P1) in Goleta and a Physician #3 (P3) in Lompoc. However, when R1 moved to Pita Board and Care in Santa Maria, RP says the licensee started taking R1 to the VA in Santa Maria for medical treatment, and communication with the POA regarding R1’s care decreased.

Continued on 9099-C

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) -59-343
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: 805-450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 29-AS-20200423161002

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE. SUITE 200
GOLETA, CA 93117

FACILITY NAME: PITA BOARD AND CARE	FACILITY NUMBER: 421703341
	VISIT DATE: 09/11/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On 4/29/2020, the LPA spoke with the licensee regarding R1 seeing the VA doctors. The licensee stated that she asked the POA if it was okay to take R1 to VA doctors, and the POA stated that it was okay, however, the preference was to keep R1 with the current doctors. The licensee states she continued to follow-up on getting R1 in to see VA doctors due to services and medications being free for R1 as a veteran. The licensee also states she sometimes couldn’t get an appointment for R1’s regular doctors for over a month and said she was not getting reimbursed for travel expenses from the POA for taking R1 from Santa Maria to Lompoc for doctor visits. The reimbursement for travel expenses was predetermined in R1’s Admission Agreement.

The LPA asked the licensee if she was sending a statement, fuel receipt, or similar to the POA to show the travel expense and request reimbursement, and she stated she had not. The licensee said she had phoned the POA requesting reimbursement, however, she had not received payment as of present. On 6/01/2020, the POA stated that R1 continues to visit R1’s original Psychiatrist #1 (P1) and Primary Physician (P3) in addition to the new doctors at the VA.

Based on this investigation, the LPA did not find sufficient evidence to support that staff is making unauthorized decisions for R1. As a result, regarding the allegation that, “Staff is making unauthorized decisions without proper consent”, at this time the finding is Unsubstantiated.

At 3:43 pm, a video chat exit interview was conducted with Gloria Pita, and an electronic copy of the report was emailed for signature, to be returned to LPA Chavez by email at darlene.chavez@dss.ca.gov.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) -59-343
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: 805-450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2020

LIC9099 (FAS) - (06/04)

Page: 4 of 4