425850241-9-20-2023-29-AS-KBUY-D9LVGQ-20240930162552

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 425850241
Report Date: 09/20/2023
Date Signed: 09/20/2023 04:56:43 PM

Substantiated

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
09/18/2023 and conducted by Evaluator Kristin Kontilis

COMPLAINT CONTROL NUMBER: 29-AS-20230918112215

FACILITY NAME:	GARDEN COURT AT VILLA SANTA BARBARA		FACILITY NUMBER:	425850241
ADMINISTRATOR:	RICK OLDS		FACILITY TYPE:	740
ADDRESS:	227 E. ANAPAMU STREET		TELEPHONE:	(805) 963-4428
CITY:	SANTA BARBARA	STATE: CA	ZIP CODE:	93101
CAPACITY:	126	CENSUS: 84	DATE:	09/20/2023
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Rick Olds, Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff do not answer resident’s call button in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kristin Kontilis conducted a subsequent complaint visit to the facility. LPA met with Administrator Mark Cortes and explained the purpose of the visit.
On the allegation, Staff do not answer resident’s call button in a timely manner: It was alleged that staff does not respond when R1’s care pendant has been pressed and R1 has had to wait 30-45 minutes before staff responds to the calls. R1 is non-ambulatory and requires assistance with toileting and brief changes. R1’s call pendant history revealed between 9/13/2023 and 9/17/2023, there were eight (8) occurrences when R1’s call pendant was pressed. Out of the eight call pendant requests, four calls were made between 6:00 am and 12:00 pm and two calls were made between 6:00 pm and 12:00 am. The eight call requests were responded to within 10-29 minutes.
Staff 1 (S1) stated sometimes the call response button does not clear the resident’s pendant. Administrator stated that on occasion, a caregiver responds to the call but the caregiver may be unable to clear

Please continue to 9099-C, Pg 2.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

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-20230918112215

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: GARDEN COURT AT VILLA SANTA BARBARA	FACILITY NUMBER: 425850241
	VISIT DATE: 09/20/2023

NARRATIVE

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the call or re-set the resident’s pendant to indicate the call is complete. Administrator stated his goal for the community is to get call pendants requests responded to within 3-5 minutes.
During the course of an interview, LPA requested a resident’s call pendant be pressed at 2:53 pm. At 3:07 pm, LPA requested the visitor to press the call pendant a second time. At 3:14 pm, the call was responded to by Staff 2 (S2).
Based upon interviews conducted, records reviewed, and observation, the allegation that staff do not answer resident’s call pendant in a timely manner is Substantiated at this time.

The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Failure to correct the deficiency may result in additional civil penalties.

Exit interview conducted. Deficiency issued. Copy of report and Appeal Rights issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20230918112215

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: GARDEN COURT AT VILLA SANTA BARBARA	FACILITY NUMBER: 425850241
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/20/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/21/2023 Section Cited CCR 87468.	1 2 3 4 5 6 7	87468.2(a)(4) …Residents…have all of the following personal rights: To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Administrator agrees to re-evaluate care response system that is conducive to residents’ needs and room location in order to decrease call response time.
	8 9 10 11 12 13 14	Based on interviews conducted, record review and observation, the licensee did not comply with the above cited section, as the licensee did not ensure resident’s call buttons were responded to timely which posed an immediate health and safety risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023

LIC9099 (FAS) - (06/04)

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