374604545-1-15-2025-08-AS-LTEZ-DDH2XX-20250201164752

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604545
Report Date: 01/15/2025
Date Signed: 01/15/2025 05:28:50 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
01/06/2025 and conducted by Evaluator Nacole Patterson

COMPLAINT CONTROL NUMBER: 08-AS-20250106152332

FACILITY NAME:	GARDENS AT ESCONDIDO		FACILITY NUMBER:	374604545
ADMINISTRATOR:	MCBRIDE, FERLINA		FACILITY TYPE:	740
ADDRESS:	1342 NORTH ESCONDIDO BLVD		TELEPHONE:	(760) 480-8155
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92026
CAPACITY:	101	CENSUS: 75	DATE:	01/15/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Executive Director Angela Scott-Kapiloff		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Licensee did not follow infection control notification policy.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced visit to initiate an investigation regarding the above complaint allegation and deliver findings. LPA introduced themselves and disclosed the purpose of the visit to Executive Director Angela Scott-Kapiloff. LPA was away from the facility from 1:15pm to 2:15pm.

On 01/06/2025 it was alleged that the Licensee did not follow the facility's infection control notification policy. The Department’s investigation consisted of an unannounced facility visit, interviews with facility staff, outside sources, and records review. Staff interviews revealed that the facility did not experience a Covid-19 outbreak during the timeframe of complaint, therefore community notification was not required. Staff informed that two (2) Covid-19 cases existed concurrently at the facility, which did not reach the level of outbreak status.

(Continued on LIC9099-p.2)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

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-20250106152332

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: GARDENS AT ESCONDIDO	FACILITY NUMBER: 374604545
	VISIT DATE: 01/15/2025

NARRATIVE

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(Continued from LIC9099 p.1)
Staff informed that the facility's required infection control protocols were put in place, including Personal Protective Equipment (PPE) carts placed outside of the affected residents' rooms, full PPE donned by staff assisting the affected residents, CDC signs placed on the affected residents' doors, notifications made to the affected residents' responsible parties and physicians, and Public Health notified. Interviews with staff revealed consistent knowledge of facility protocols regarding infection control procedures at the facility.

The information provided by staff regarding the infection control protocols that were in place were corroborated by facility records. The facility's Illness Tracking Form during the timeframe of complaint showed that five (5) Covid-19 cases existed at the facility. The tracking showed that at most, two (2) residents were under isolation protocols concurrently. Narrative Charting Notes for the residents in question during the timeframe of complaint corroborated staff statements that the physicians and responsible parties for the residents in question were notified of the positive COVID-19 test results. The infection control process outlined by staff was corroborated by the facility's Infection Control Plan, dated 07/01/2023. The Infection Control Plan was absent of directives regarding when the community should be notified of positive Covid-19 cases.

Outside source interview with the facility's infection control trainer revealed that the recommendation was for communities to be notified of COVID-19 when the facility reached outbreak status, which was three (3) or more cases occurring at the same time. The outside source did not express concern regarding the facility's adherence to Covid-19 protocols and regulations. Staff statements regarding contacting Public Health were corroborated through website tracking verification with date and timestamps.

LPA directly observed the facility's infection protocol specific to COVID-19. LPA observed the use of PPE, disinfectant and sanitation practices, and CDC signage. The observations made by LPA were consistent with staff interviews, outside source interviews, and records review. The investigation did not produce evidence that the Licensee did not follow their infection control notification policy.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. An exit interview was conducted with Executive Director Angela Scott-Kapiloff, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

LIC9099 (FAS) - (06/04)

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