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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604138
Report Date: 07/03/2024
Date Signed: 07/03/2024 04:34:38 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, 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
06/27/2024 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20240627094003
FACILITY NAME:PREMIUM CARE SERVICESFACILITY NUMBER:
374604138
ADMINISTRATOR:HAFIZ, SHEIKHFACILITY TYPE:
740
ADDRESS:8243 HYDRA LNTELEPHONE:
(858) 433-7319
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:6CENSUS: 6DATE:
07/03/2024
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Staff, Roser LojaTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Licensee did not ensure a comfortable temperature was maintained for residents at all times
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and discussed the allegation mentioned above with Staff, Roser Loja.

During today's visit, LPA briefly toured the facility, interviewed staff and residents. It was alleged the licensee did not ensure a comfortable temperature was maintained for residents at all times. It was reported the facility's temperature was 88 degrees F. on 06/25/24. An online review of AccuWeather indicated the weather on 06/25/24 was 83 degrees F. in the Mira Mesa area. Outside source interviews revealed a resident was hot and sweating in their bed due to the hot temperature of 88 degrees F. on 06/25/24. Staff and resident interviews confirmed the resident that was in bed sweating has a shared room and the resident's roommate turned off the fan, due to feeling cold. Even though the facility’s temperature reached 88 degrees F. not all residents were hot, due to different body temperatures. Continued on an LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20240627094003
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: PREMIUM CARE SERVICES
FACILITY NUMBER: 374604138
VISIT DATE: 07/03/2024
NARRATIVE
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The facility has multiple residents with different body temperatures. Today's temperature outside was 79 degrees F. The facility's thermostat today reflected 81 degrees F. LPA observed a resident wearing a shirt, sweater and under two blankets. Resident interviews confirmed it was not too hot. Some residents were cold with the use of the fans today but made aware it was necessary to keep the facility's temperature within regulation.

Staff interviews revealed the facility was not too hot and there are multiple fans in use, along with the doors and windows left open. LPA observed one (1) portable air conditioning unit, one (1) tower fan, and a working ceiling fan located in the room in which the resident was hot and sweating, all in use. The roommate complained today it was too cold. The staff has positioned the portable air conditioning unit towards the resident that was hot, so that it would not affect the roommate.

Staff also indicated they provide blankets and jackets to the residents that may cold, to ensure the facility's temperature is regulated. The facility has one (1) portable air conditioning unit; twelve (12) fans; and five (5) ceiling fans throughout the facility. They also have four (4) extra fans and two (2) extra portable air conditioning units located in the garage for resident use. LPA observed one (1) resident had three (3) fans in their room but only one (1) in use, by choice. Another resident requested the fan be turned off. Due to multiple residents with different body temperatures, the facility is ensuring to meet each resident’s needs regarding the facility temperature.

During the course of the investigation, interviews were conducted, and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. The allegation is deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Staff, Roser Loja whose signature below confirms receipt of these rights.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC9099 (FAS) - (06/04)
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