374602785-2-14-2024-08-AS-JLOT-D3BK4E-20240313073409

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602785
Report Date: 02/14/2024
Date Signed: 02/14/2024 10:06:57 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/01/2020 and conducted by Evaluator Rebecca A Ruiz

COMPLAINT CONTROL NUMBER: 08-AS-20201201112638

FACILITY NAME:	BERLAND HOME CARE		FACILITY NUMBER:	374602785
ADMINISTRATOR:	PARAISO, DENNIS		FACILITY TYPE:	740
ADDRESS:	512 BERLAND WAY		TELEPHONE:	(619) 205-4600
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	6	CENSUS: 5	DATE:	02/14/2024
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Administrator May Paraiso		TIME COMPLETED:	10:10 AM

ALLEGATION(S):

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Licensee's neglect of resident resulted in malnourishment
Licensee's neglect of resident resulted in dehydration
Licensee did not assist resident with incontinence care
Licensee neglect resulted in resident wearing dirty clothing

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 Administrator May Paraiso.

The Department’s investigation consisted of interviews with staff and outside sources and a virtual tour of the facility. It was alleged that the Licensee’s neglect of resident resulted in malnourishment and dehydration, Licensee did not assist resident with incontinence care, and Licensee’s neglect resulted in resident wearing dirty clothing. Interviews with staff and outside sources revealed that in 2020, the facility cared for residents with major cognitive impairments and several residents required assistance with all activities of daily living, including Resident 1 (R1). Interviews with staff and outside sources described R1 as having a diagnosis of major cognitive impairment, received hospice services, required assistance with ambulation, grooming, dressing, and showering, and used incontinence briefs.
Continued on LIC9099-C page...

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

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-20201201112638

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BERLAND HOME CARE	FACILITY NUMBER: 374602785
	VISIT DATE: 02/14/2024

NARRATIVE

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Interviews with staff revealed that staff assisted residents with showers or bed baths two to three times a week unless the resident was receiving hospice services. In that event, the hospice agency would be responsible for providing showers or bed baths. Staff stated that residents were changed from sleeping clothing into daytime clothing in the morning and staff changed resident clothing as necessary if the clothing became wet, soiled, or dirty. Interviews did not reveal that any residents had a pattern of consistently refusing showers. Residents who wore incontinence briefs were checked by staff multiple times a day and were changed as needed. During an on-site visit in January 2024, LPA Ruiz did not detect any smell of urine or other foul odors. Interviews with staff and outside sources indicated that staff assisted residents with eating meals and encouraged hydration by providing all residents with a cup for water that was kept near the resident. Staff verbally encouraged residents to drink water and finish eating their meals and would notify the Administrator if a resident did not finish all of a meal multiple days in a row. Interviews confirmed that R1 required encouragement to eat meals but did not experience any decline in meal portions eaten. Interviews revealed that staff did not regularly weigh residents at the facility unless a resident had a doctor’s order but would document a resident’s weight from medical records.

Interviews with outside sources described staff as attentive, compassionate, and patient, and did not voice any concerns regarding resident cleanliness, observations in changes of conditions, or staff to resident interactions. Interviews with outside sources did not reveal any concerns regarding the care and supervision provided by the facility and did not support the validity of the allegations. The Department was unable to interview R1 due to R1 passing away and the Department was unable to secure facility records for 2020 due to the requirement that facilities must maintain records for 3 years only.

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

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

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

LIC9099 (FAS) - (06/04)

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