374601097-12-7-2023-08-AS-DPOL-CYQNYQ-20231221095307

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601097
Report Date: 12/07/2023
Date Signed: 12/07/2023 05:24:54 PM

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
11/30/2023 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20231130145404

FACILITY NAME:	CASA DEL SOL		FACILITY NUMBER:	374601097
ADMINISTRATOR:	VIDA DACANAY		FACILITY TYPE:	740
ADDRESS:	4290 LAYLA WAY		TELEPHONE:	(619) 662-1979
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY:	6	CENSUS: 4	DATE:	12/07/2023
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Administrator, Vida Dacanay		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Licensee did not provide residents a clean room
Staff did not meet the resident’s care needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced complaint visit to deliver investigative findings. LPA met with Administrator, Vida Dacanay, and shared findings.

The Department investigated the above-listed complaint allegations. The investigation consisted of observations, a review of relevant records, and interviews with facility staff, and outside sources.

On November 30, 2023, Community Care Licensing (CCL) received a complaint alleging that the licensee did not provide residents with a clean room. It was specifically alleged that a resident (R1) living at the facility diagnosed with dementia had fecal smearing (Scatolia) behavior and was throwing fecal matter inside the perimeter of their shared room. It was further alleged that staff did not thoroughly clean after R1’s alleged Scatolia behavior. During a visit conducted on December 5, 2023, the facility was observed to be clean, organized, and free from bad odors.
(Continue at LIC9099)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

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-20231130145404

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: CASA DEL SOL	FACILITY NUMBER: 374601097
	VISIT DATE: 12/07/2023

NARRATIVE

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(Continue from LIC9099)

The residents’ rooms and bathrooms were also observed to be orderly and equipped with all the furnishings and amenities as required by Title 22 regulations. During multiple interviews, staff, residents, and outside sources consistently indicated they had not witnessed R1’s alleged behavior. In addition, residents and outside sources did not voice any concerns regarding staff not cleaning the residents’ rooms. A review of R1’s medical records and service care plan did not disclose Scatolia as a problem behavior for R1.

It was also alleged that staff did not meet a resident’s (R2) care needs. It was specifically alleged that R2 would call for assistance multiple times during the night shift and no staff would attend to their needs. During interviews, R2 stated they called law enforcement multiple times at nighttime to come to the facility to get the facility staff’s attention. When asked, R2 indicated they called staff for various non-emergency situations, such as repositioning pillows for comfort, medication, and room temperature changes. A review of R2’s medical records and service care plan did not indicate that R2 was diagnosed with a critical medical condition that required 24/7 care and supervision. In addition, a review of R2’s medication administration records indicated that facility staff administered medication as prescribed. On December 5, 2023, law enforcement confirmed they responded to R2’s calls seven different times during November 2023. On November 28, 2023, R2 was admitted to the hospital for psychiatric assessment.

The Department has investigated the above-mentioned allegations and based on interviews with staff, residents, outside sources, and records review, the preponderance of the evidence has not been met, therefore, these allegations are deemed unsubstantiated.

An exit interview was conducted with Administrator, Vida Dacanay, to whom a copy of this report and the Licensee Appeal Rights (LIC9058 01/16) was provided at the conclusion of the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

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