374603509-5-22-2024-08-AS-IESA-D5TSS5-20240601140722

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603509
Report Date: 05/22/2024
Date Signed: 05/22/2024 11:26:00 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/12/2021 and conducted by Evaluator Becky Kennedy

COMPLAINT CONTROL NUMBER: 08-AS-20210212154050

FACILITY NAME:	WESTMONT AT SAN MIGUEL RANCH		FACILITY NUMBER:	374603509
ADMINISTRATOR:	NEWTON, RANDAL		FACILITY TYPE:	740
ADDRESS:	2325 PROCTOR VALLEY RD		TELEPHONE:	(619) 271-4385
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91914
CAPACITY:	105	CENSUS: 77	DATE:	05/22/2024
		UNANNOUNCED	TIME BEGAN:	10:57 AM
MET WITH:	Ellen Argullo		TIME COMPLETED:	12:43 PM

ALLEGATION(S):

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Resident's care plan does not accurately represent the care provided

INVESTIGATION FINDINGS:

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Licensing Program Analyst Becky Kennedy concluded the investigation which began on 3/18/21. LPA Kennedy made an unannounced visit to the above facility today and met with Ellen Argullo, Business Office Manager. LPA advised them of the reason for today's visit and delivered the investigation findings on the above allegation.

It was alleged that Resident 1’s (R1) care plan does not accurately represent the care provided.

The investigation included interviews with internal and external sources, review of records, and a virtual tour of the facility.

Interviews revealed that R1 had an insurance Policy that would reimburse R1 for some services. R1 had multiple conversations with facility administration to modify the care plan so that R1 could access insurance reimbursements. It was further revealed that R1 would periodically refuse services that were on the care plan and request services that were not on the care plan.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
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)

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Control Number 08-AS-20210212154050

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: WESTMONT AT SAN MIGUEL RANCH	FACILITY NUMBER: 374603509
	VISIT DATE: 05/22/2024

NARRATIVE

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R1 was concerned about what care required an extra fee and what would be reimbursed.

The primary concern raised in the investigation was what, and how services were written on the case plan to receive reimbursement form R1’s insurance company. The investigation did not reveal evidence that the care plan was not accurate regarding the services R1 was offered or received.

The preponderance of evidence standard has not been met and this allegation is unsubstantiated.

An exit interview was conducted with Ellen Argullo, Business Office Manager. A copy of this report along with Licensee Rights (LIC9058 01/2016) was left at the facility.

SUPERVISOR'S NAME: Icela Estrada	TELEPHONE: (619) 688-6866
LICENSING EVALUATOR NAME: Becky Kennedy	TELEPHONE: 619-672-5843
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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