374604108-2-13-2024-08-AS-LTEZ-D2W2GA-20240228162250

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604108
Report Date: 02/13/2024
Date Signed: 02/13/2024 01:54:44 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/14/2020 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20201014134932

FACILITY NAME:	PERPETUAL HELP HOME CARE		FACILITY NUMBER:	374604108
ADMINISTRATOR:	RAMIREZ, JOSE & HELEN		FACILITY TYPE:	740
ADDRESS:	29531 MACTAN RD		TELEPHONE:	(709) 913-5580
CITY:	VALLEY CENTER	STATE: CA	ZIP CODE:	92082
CAPACITY:	6	CENSUS: 6	DATE:	02/13/2024
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Administrator Raymond Ramirez and Caregiver Elvira Mangabat		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Staff did not have required training
Staff did not treat residents with dignity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced follow-up investigation visit and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Elvira Mangabat. Administrator Raymond Ramirez arrived during the visit and assisted the LPA.

Throughout the investigation, the Department secured pertinent records and conducted interviews with sources.

It was alleged the staff did not have the required training. It was reported to the Department staff were assisting residents with medications. Interviews with multiple sources did not reveal concerns with lack of assistance from staff. Records obtained from the facility revealed care staff had received medication assistance training.
(See LIC 9099C for continuation of report.)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024

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-20201014134932

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: PERPETUAL HELP HOME CARE	FACILITY NUMBER: 374604108
	VISIT DATE: 02/13/2024

NARRATIVE

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It was alleged staff did not treat residents with dignity. A source reported to the Department staff had treated a resident in a mean way. This source did not provide any specific action from staff, nor a timeframe. Interviews with several sources did not reveal any concerns with staff not treating residents with dignity, and revealed staff treated residents well. Sources also revealed residents may have raised their voices at staff and other residents.

Based on the evidence gathered throughout the investigation, the allegations were unsubstantiated.

An exit interview was conducted with Administrator Ramirez, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided via electronic mail. An electronic mail read receipt confirms the documents were received by Ramirez.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024

LIC9099 (FAS) - (06/04)

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