374601046-11-7-2023-08-AS-LTEZ-CXT2NK-20231121163253

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601046
Report Date: 11/07/2023
Date Signed: 11/07/2023 03:39:16 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/13/2020 and conducted by Evaluator Rebecca A Ruiz

COMPLAINT CONTROL NUMBER: 08-AS-20200713092605

FACILITY NAME:	BROOKDALE PLACE OF SAN MARCOS		FACILITY NUMBER:	374601046
ADMINISTRATOR:	HEILGEIST, MARY ELLEN		FACILITY TYPE:	740
ADDRESS:	1590 W SAN MARCOS BLVD		TELEPHONE:	(760) 471-9904
CITY:	SAN MARCOS	STATE: CA	ZIP CODE:	92078
CAPACITY:	245	CENSUS: 151	DATE:	11/07/2023
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Executive Director Mario Preston		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff did not have the required training to care for residents
Resident rooms were not kept sanitary
Licensee did not ensure personnel requirements were met

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegations. LPA identified herself to, was greeted by, and explained the purpose of the visit to Executive Director Mario Preston.

The Department’s investigation consisted of interviews with staff, residents, and outside sources, records review, and a tour of the facility. It was alleged that staff did not have the required training to care for residents, specifically for dementia and transferring, resident rooms were not kept sanitary, and licensee did not ensure personnel requirements were met. Interviews and review of the facility’s license revealed that the facility cared for both ambulatory and non-ambulatory residents as well as residents receiving hospice care. Interviews with staff and review of resident records revealed that the facility did not usually care for residents diagnosed with dementia but would occasionally care for residents with dementia that was not advanced.

Continued on LIC9099-C page...

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

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 08-AS-20200713092605

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: BROOKDALE PLACE OF SAN MARCOS	FACILITY NUMBER: 374601046
	VISIT DATE: 11/07/2023

NARRATIVE

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Review of training documents for direct care staff who worked at the facility in 2020 revealed that staff received training on topics such as caring for residents with dementia and Alzheimer’s, medication management, the aging process, fall management, proper lifting techniques, the use of gait and transfer belts, and safe resident transfers. Interviews with staff revealed that they received monthly training assignments, felt well trained to care for the residents present at the facility, and would reach out to a nurse, hospice agency, or facility management if they felt they needed additional training.

Review of direct care staff schedules for June and July 2020 revealed that the Licensee scheduled between 3-4 caregivers and 2 med-techs for the AM and PM shifts, and about 2 caregivers and 1 med-tech scheduled for the overnight shift. On at least 2 occasions, there were 2 caregivers and 2 medtechs working during the PM shift. Interviews with facility management revealed that if a scheduled staff called out prior to their shift, management would attempt to arrange staff coverage of the shift. If the facility was unable to locate a staff member to cover the shift, medtechs would assist caregivers with resident care. Interviews with residents did not reveal any instances where resident care was not provided due to the staffing level of the facility. Interviews with staff provided conflicting information regarding staffing levels and the staff’s ability to complete resident care needs.

The facility was toured virtually in July 2020 and LPA Wu observed multiple resident rooms, a majority of which were observed to be clean. One resident room was observed to be cluttered with the resident’s personal items. Interviews with the facility administrator revealed that residents were provided weekly housekeeping and laundry services by housekeeping staff. Housekeepers were tasked with cleaning a single resident room within 20 minutes. Additionally, housekeeping staff were not permitted to move resident belongings to be able to clean the room. Interviews with the Administrator revealed that the facility did not have any policies regarding hoarding situations. LPA Ruiz conducted a facility walkthrough in October 2023 and observed multiple resident rooms, all of which were clean and did not have any foul odors. Interviews with residents and staff did not reveal any issues with dirty or cluttered resident rooms or foul odors. Interviews with facility management, residents, and staff revealed that the facility allowed pets and offered dog walking and litterbox cleaning services if the resident was unable to care for the pet.

Continued on LIC9099-C page...

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20200713092605

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
Lookup Error,
, CA

FACILITY NAME: BROOKDALE PLACE OF SAN MARCOS	FACILITY NUMBER: 374601046
	VISIT DATE: 11/07/2023

NARRATIVE

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Interviews revealed that the service was offered both as a courtesy or as a paid service and caregivers would provide the services for residents. Interviews revealed that pets would occasionally relieve themselves in resident rooms either due to unfamiliarity with the new environment or accidents. Interviews did not reveal any lingering odors related to pet waste.

The Department has investigated the above-mentioned allegations and based on interviews, observation, and record review, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated.

An exit interview was conducted with Executive Director Mario Preston, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 01/16).

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Rebecca A Ruiz	TELEPHONE: (619) 318-7620
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

LIC9099 (FAS) - (06/04)

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