374604293-5-29-2024-08-AS-SJAB-D5RV55-20240530160723

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604293
Report Date: 05/29/2024
Date Signed: 05/29/2024 11:13:15 AM

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
08/25/2020 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20200825110415

FACILITY NAME:	SEABRIGHT ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	374604293
ADMINISTRATOR:	CHOUDRY, SAHER		FACILITY TYPE:	740
ADDRESS:	831 SANTA REGINA		TELEPHONE:	(858) 302-1366
CITY:	SOLANA BEACH	STATE: CA	ZIP CODE:	92075
CAPACITY:	6	CENSUS: 5	DATE:	05/29/2024
		UNANNOUNCED	TIME BEGAN:	09:43 AM
MET WITH:	Celeste Valdivia		TIME COMPLETED:	11:20 AM

ALLEGATION(S):

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Licensee failed to provide a preadmission fee refund
Staff not properly trained
Staff failed to allow resident to make and receive confidential calls
Staff camouflaged medication without the consent or knowledge of the resident.
Staff failed to administer correct dose of medication to resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced visit to deliver investigative findings. LPA was granted entry into the facility and met with Caregiver Celeste Valdivia to whom LPA explained the purpose of the visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegations. The investigation consisted of review of records and interviews with staff, residents and outside sources.

It was alleged that Licensee failed to provide a preadmission fee refund to Resident 1 (R1) (an LIC 811 Confidential Names List was provided to the facility representative to identify the resident) LPA interviewed administrator who stated that R1's accountant did not pay for R1's final month at the facility and instead wanted to only pay for three days. Administrator further stated that R1 has a remaining balance due since R1's accountant never paid for facility fees including a haircut that was paid for by the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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-20200825110415

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: SEABRIGHT ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 374604293
	VISIT DATE: 05/29/2024

NARRATIVE

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Upon review of records and the facility's admission agreement it was determined that the preadmission fee refund policy was clearly outlined and adhered to appropriately.

It was alleged that staff were not properly trained. It was reported that staff did not have proper medication training. LPA interviewed staff member 1 (S1) who stated that she feels properly trained and she also helps the other caregivers in the facility. The training includes; medication disbursement, PRN's, new medications, etc. Interviews with staff members and examination of training records indicated that the facility maintains comprehensive training programs for all staff members in accordance with licensing requirements. There were no indications of inadequate training.

It was alleged that facility staff failed to allow R1 to make and receive confidential calls. LPA interviewed Resident 2 (R2) who stated that R2 has their phone at there bedside and are able to make private phone calls. R2 further stated that R2 has never had any incidents where staff were "eavesdropping" during R2's phone calls. LPA interviewed S1 who stated that if a resident is not able to hold the phone the staff will advise the person on the phone if it is okay that they hold the phone. The staff will then do as they are told. There were no documented instances of interference with resident communication rights.

It was alleged that facility staff camouflaged medication without the consent or knowledge of R1. LPA interviewed S1 who stated that S1 stated that caregivers are not allowed to "crush" medication or PRN's. S1 stated that she has advised other staff that they are not allowed to crush medication. S1 stated that the Administrator is "on top" of the policy and procedures. Review of medication administration procedures and interviews with staff members and residents revealed no evidence to support the claim of medication camouflage without consent. The facility adheres to strict medication administration protocols.

It was alleged that staff failed to administer correct dose of medication to R1. Interviews with facility personnel and records review confirmed that the facility follows established protocols to ensure accurate dosage administration to residents. There were no documented instances of incorrect medication dosage administration.

LPA interviewed outside agency (OA) who stated that they had no information or knowledge regarding these allegations. OA further stated that there was "nothing in the system" for the time period of the complaint.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 08-AS-20200825110415

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: SEABRIGHT ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 374604293
	VISIT DATE: 05/29/2024

NARRATIVE

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LPA interviewed Administrator who stated that all of the facility staff are well trained in every area including medication. Administrator stated that R1 was only at the facility for a short while. Administrator stated that R1's family was bringing in medication for R1 without a doctor's order and were telling staff to give the medication to R1. Administrator advised the family that they needed a doctor's order and also advised the family of the fee to be seen by a doctor. Administrator stated that the family did not want to pay the fee and that is when the "issues" started.

Based upon the foregoing, the above listed allegations are unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegations are not valid.

An exit interview was conducted with Celeste Valdivia . A copy of this report along with licensee rights (LIC 9058, 3/22) was provided to Celeste Valdivia whose signature below verifies receipt of these rights.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC9099 (FAS) - (06/04)

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