565802425-6-20-2023-29-AS-JAPL-CT9W28-20230629165355

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802425
Report Date: 06/20/2023
Date Signed: 06/20/2023 03:42:11 PM

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
12/10/2021 and conducted by Evaluator Angel Ascencio

COMPLAINT CONTROL NUMBER: 29-AS-20211210101025

FACILITY NAME:	PACIFICA SENIOR LIVING OXNARD		FACILITY NUMBER:	565802425
ADMINISTRATOR:	GUTIERREZ, SARA		FACILITY TYPE:	740
ADDRESS:	2211 E GONZALES RD		TELEPHONE:	(805) 983-6808
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY:	100	CENSUS: 47	DATE:	06/20/2023
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Elizabeth Whittington		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Staff are hitting resident
Staff are not safeguarding resident's personal belongings
Staff yell at resident
Staff are mismanaging resident's medication

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angel Ascencio conducted a subsequent visit to the above facility to deliver findings. LPA Ascencio met with Executive Director (ED) Elizabeth Whittington at 09:50 a.m. Entrance interview conducted.

On 12/10/2021, the Department received a complaint alleging that staff are hitting residents, staff are not safeguarding resident’s personal belongings, staff yell at resident and staff are mismanaging resident’s medication. On 12/13/2021, starting at 12:25 p.m., LPA Ascencio conducted an interview with Staff #1 (S1). Interview with S1 revealed that they have not heard of any staff hitting residents. Additionally, S1 added that during their training, one of the topics for training is Elder Abuse and how to report it. Later that same day, interview at 1:30 p.m., with Resident #1 (R1) on 12/13/2021 revealed that they have not been hit by staff but instead are pushed by staff members when they are assisting R1 with their activities of daily living (ADL). Additionally, R1 stated that staff members rush R1 and are not sensitive to R1’s mobility.
Continued on LIC 9099 - C Page 1

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angel Ascencio	TELEPHONE: 747-230-3888
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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-20211210101025

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: PACIFICA SENIOR LIVING OXNARD	FACILITY NUMBER: 565802425
	VISIT DATE: 06/20/2023

NARRATIVE

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Interview with various staff members on 03/01/2023, starting at 12:35 p.m. revealed that they have not seen or heard of any residents being physically abused by staff members. Staff stated that if they were to observe or hear of any physical abuse, they would the Ombudsman hotline, Community Care Licensing (CCL), and let their supervisor know. Lastly, staff interviews indicated that although some residents are difficult to manage, staff take their time to help with their needs and ADL’s. On 05/03/23, starting at 2:30 p.m. and on 05/05/2023, starting at 11:08 a.m., interview with residents revealed that no staff has hit them during care. Additionally, resident interviews added that the staff are nice, polite, and very professional when assisting residents.

Based on the evidence gathered throughout the investigation, there is insufficient evidence to support the allegation that staff are hitting residents. Thus, the allegation is deemed unsubstantiated at this time.

Regarding the allegation of staff are not safeguarding resident's personal belongings. Interviews with residents on 12/13/2021 starting at 1:30 p.m., and on 05/05/2023, starting at 11:08 a.m., revealed that they have not had any personal belongings missing from their apartments. Additionally, residents stated leaving various items of value in their room and had not had any problems with them being lost of stolen. Interview with R2, on 05/03/23, starting at 2:30 p.m. revealed that a missing bottle of moisturizer had gone missing at one point and was never found. Interview with R3, on 05/05/2023, starting at 11:26 a.m. revealed that they had about $80.00 cash in a wallet on their countertop that was missing. R3 added that they could not remember the exact date but was sure there was $80.00 in their wallet. Either way, R3 did not want to report it to management or police enforcement and stated to “forget about it”.

Interview with staff members on 12/13/2021, starting at 12:25 p.m., and on 03/01/2023, starting at 12:35 p.m. revealed that they have not seen or heard of any personal belonging from resident that have gone missing, lost or stolen. Additionally, staff stated that resident misplace their personal belonging throughout the facility and forget where they place those items. Residents are quick to assume their items were stolen by staff. Once the item is found, the residents are happy their belongings have returned.

Although staff interviews stated that they have not heard of any personal belongings of residents that have been stolen, staff indicated that residents misplace items which are found by staff within a few days. Additionally, interviews with R2 revealed that a moisturizer was missing while R3 stated that $80.00 was missing from their wallet.

Continued on LIC 9099 - C Page 2

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angel Ascencio	TELEPHONE: 747-230-3888
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 29-AS-20211210101025

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: PACIFICA SENIOR LIVING OXNARD	FACILITY NUMBER: 565802425
	VISIT DATE: 06/20/2023

NARRATIVE

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Both R2 and R3 indicated they did not want to pursue any formal complaint regarding the missing items. Although the allegations may have happened, there is insufficient evidence to support the allegation that staff are not safeguarding the resident’s personal belongings.

LPA Ascencio spoke with Administrator Elizabeth Whittington regarding residents missing items. Administrator Whittington stated they will conduct staff training on safeguarding personal belonging to prevent any future incidents.

Regarding the allegation staff are yelling at residents. Interviews with residents on 12/13/2021 starting at 1:30 p.m., 05/03/23, starting at 2:30 p.m. and on 05/05/2023, starting at 11:08 a.m., revealed that staff have not yelled or screamed at residents while in care. Additionally, residents stated that most staff members are very nice, and professional who are willing to go out of their way to help residents out. Residents added that there are times staff speak a bit loud that it can be mistaken as yelling, but no yelling occurs. Lastly, resident interviews added that although most staff members are good, but there are some staff who come in, do their job and leave, not putting in the extra effort for us residents.

Interview with staff members on 12/13/2021, starting at 12:25 p.m., and on 03/01/2023, starting at 12:35 p.m. revealed that they have not seen or heard of any staff member yelling at residents while in care. Additionally, staff stated that they speak to resident loudly for them to hear but not yell at residents.

Thus, based on evidence gathered throughout the investigation, there is insufficient evidence to support the claim that staff are yelling at residents.

Lastly, regarding the allegation of staff are mismanaging resident’s medication. Interviews with residents on 05/03/23, starting at 2:30 p.m. and on 05/05/2023, starting at 11:08 a.m., revealed that some residents manage their own medication while other residents are helped with the self-administration of medication by the facility staff. Those residents who the facility staff assist with self-administration of medication, revealed that their medication has never been missed, arrives on time and is always available if needed. On 06/20/2023, starting at 01:10 p.m., a medication audit was conducted for residents R1, R4 and R5. Medication audit revealed that R1, R4 and R5 have a current supply of routine and “as needed” (PRN) medication for anxiety. Thus, based on the interviews and medication audit, there is insufficient evidence to support the allegation of staff are mismanaging resident’s medication. The allegation is deemed unsubstantiated at this time.

Exit interview conducted and a copy of the report was issued to ED Whittington. Page 3

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angel Ascencio	TELEPHONE: 747-230-3888
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC9099 (FAS) - (06/04)

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