374604407-5-7-2025-08-AS-APAO-DGNVNG-20250514163508

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604407
Report Date: 05/07/2025
Date Signed: 05/07/2025 04:57:23 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
04/30/2025 and conducted by Evaluator Hannah Rodgers

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20250430092915

FACILITY NAME:	BAYSHIRE CARLSBAD		FACILITY NUMBER:	374604407
ADMINISTRATOR:	DAYNES, THOMAS		FACILITY TYPE:	741
ADDRESS:	3140 EL CAMINO REAL		TELEPHONE:	(760) 720-9898
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	125	CENSUS: 109	DATE:	05/07/2025
		UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Resident Services Director Pamela Talamantes		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff handled resident in a rough manner
Staff did not treat resident with dignity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced visit to initiate and deliver findings regarding the above complaint allegations. LPA introduced themselves and disclosed the purpose of the visit to Executive Director Ozz Daynes. Resident Services Director Pamela Talamantes arrived later during the visit.

On April 30, 2025, it was alleged that staff handled resident in a rough manner and staff did not treat resident with dignity. It was alleged that Staff #1 (S1) had shoved Resident #1 (R1) with their transfer board while also using inappropriate language toward R1 [See LIC811 Confidential Name List for identification of select person identifiers used in this report]. The Department’s investigation consisted of an unannounced facility visit, records review, and staff, resident, and outside source interviews.

(CONTINUED ON LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Hannah Rodgers
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025

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-20250430092915

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: BAYSHIRE CARLSBAD	FACILITY NUMBER: 374604407
	VISIT DATE: 05/07/2025

NARRATIVE

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Per record review and staff interviews, on April 27, 2025, R1 was receiving assistance from S1 and Staff #2 (S2) during a transfer to their wheelchair. R1 was in the restroom prepping to be transferred to their wheelchair. During this incident S1, while assisting R1, attempted to use their transfer board. R1 began to get frustrated with S1 and expressed this frustration verbally. Interviews did not reveal that S1 handled R1 in a rough manner nor did it reveal that S1 spoke to R1 inappropriately during this incident.

Review of R1’s physician’s report dated March 21, 2025, revealed that R1 could feed themselves but required assistance with all other activities of daily living. Review of R1’s resident assessment dated March 27, 2025, revealed R1 needs a two-person total assist for transfers. Interviews verified this need for R1 and thus explained the presence of S2 to witness the incident with R1 and S1.

Based on interviews and records review, the investigation did not yield a preponderance of evidence to conclude that staff handled resident in a rough manner and did not treat resident with dignity. Based on the foregoing, the allegations are unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted with Resident Services Director Talamantes, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Hannah Rodgers
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025

LIC9099 (FAS) - (06/04)

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