374603125-5-20-2025-08-AS-LTEZ-DH6W24-20250530165343

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603125
Report Date: 05/20/2025
Date Signed: 05/20/2025 01:41:54 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
08/26/2024 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20240826160702

FACILITY NAME:	RANCHO SANTA FE VILLA		FACILITY NUMBER:	374603125
ADMINISTRATOR:	BAHA, RAY CYRUS		FACILITY TYPE:	740
ADDRESS:	8292 RUN OF THE KNOLLS		TELEPHONE:	(858) 361-3322
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92127
CAPACITY:	6	CENSUS: 3	DATE:	05/20/2025
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Administrator Ray Baha		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff were unqualified.
Facility did not have an auditory device at exit doors
Facility did not have sufficient staff to meet a resident’s needs
Staff did not follow admission agreement

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced follow up complaint investigation visit and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Administrator Ray Baha.

Throughout the investigation, the Department secured records and conducted interviews with external and internal sources, including staff and residents.

It was alleged staff were unqualified. On August 26th, 2024, it was reported to the Department that staff were not able to communicate with residents. Interviews with internal and external sources did not reveal any concerns with staff not understanding residents or not being able to communicate.

(See LIC 9099-C for continuation of report.)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025

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-20240826160702

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: RANCHO SANTA FE VILLA	FACILITY NUMBER: 374603125
	VISIT DATE: 05/20/2025

NARRATIVE

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One source reported it could be frustrating to communicate with one of the staff members, but this source also disclosed there were multiple staff present to address any misunderstanding. Additionally, the LPA conducted interviews with facility staff and was able to hold conversations.The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

It was alleged the facility did not have auditory devices at exit doors. On August 26th, 2024, it was reported to the Department several exit doors at the facility did not have auditory devices. During an unannounced visit, the LPA witnessed several exit doors did not have auditory devices. The LPA also witnessed several of the exit doors were covered with plastic coverings.

An interview with the administrator revealed the facility was in the process of painting a portion of the facility and some of the auditory devices were removed to avoid any damage to the devices. Records reviewed for the four residents in care revealed one resident was diagnosed with Mild Cognitive Impairment (MCI), but did not require assistance with activities of daily living and could leave the facility unassisted. One resident was diagnosed with dementia but required assistance transferring out of bed. Two residents were diagnosed with MCI and one required assistance with transferring out of bed. The second resident with MCI was ambulatory and could be confused at times. Per Dementia Care regulations, the facility must have auditory devices, or alert features to monitor exit doors when residents are at risk of elopement.

There were no noted behaviors of wondering, or elopement from any of the residents, and the resident diagnosed with dementia required assistance with transferring out of bed. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

It was alleged the facility did not have sufficient staff to meet a resident’s needs. On August 26th, 2024, it was reported staff did not respond to assist a resident, because there was insufficient staffing. Interviews with internal and external sources did not have any concerns with staff not having sufficient staff. Interviews with the administrator and staff revealed the facility did not maintain hard copies of schedules, but there were two to three staff working the first shift from 7 AM to 7PM. There were at least two staff at the facility during the second shift from 7 PM to 7AM.

(See additional LIC 9099-C for continuation of report.)

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20240826160702

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: RANCHO SANTA FE VILLA	FACILITY NUMBER: 374603125
	VISIT DATE: 05/20/2025

NARRATIVE

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The administrator resided at the facility and would assist when needed.

Review of resident records revealed there were four residents residing at the facility. One resident did not require assistance with activities of daily living and was independent. The remaining three residents required assistance with transferring, dressing, bathing, and toileting. One of these residents employed a private caregiver Monday through Friday from approximately 9 AM to 5pm. Based on the evidence obtained the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

It was alleged staff did not follow an admission agreement. On August 26th, 2024, it was reported to the Department that the facility did not assist Resident # 1 (R1) with daily exercises, nor room cleaning as indicated in the admission agreement. Staff reported staff would attempt to clean R1’s bedroom on a weekly basis, but R1’s spouse, who also resided at the facility, would decline and discourage staff from assisting R1. Staff would assist R1 with exercises, but R1’s health had declined and R1 spent more time sleeping or sitting on R1’s chair.

Interviews with additional internal and external sources did not have any concerns with lack of bedroom cleaning, nor with the admission agreement not being followed. Based on the evidence obtained, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Administrator Ray Baha, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058),were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025

LIC9099 (FAS) - (06/04)

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