Twain Residential Care

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Kayla Hilario conducted an unannounced Case Management visit. LPA identified herself, discussed the purpose of the visit. LPA was allowed entry by caregiver Edmund Patawaran and met with caregiver Reynaldo Abit. Administrator Leonardo Simsuangco arrived during the visit. The Care Provider Management Bureau (CPMB) submitted an Order to Individual of Immediate Exclusion, dated 09/16/2022 for Individual #1 (I1). [See LIC 811 Confidential Names List for a description of I1]. Administrator Leonardo Simsuangco confirmed that I1's employment was terminated on 09/07/2022, with I1 receiving his last employment paycheck dated 09/15/2022. LPA confirmed that I1 was not included with with batch of employee paychecks stubs for 09/16/2022- 09/30/2022. No deficiencies were cited or observed on this date. An exit interview was conducted with Leonardo Simsuangco to whom copy of this report and appeal rights (LIC 9058 03/22) were provided via hardcopy at the conclusion of the visit.the state’s words, verbatim · CDSS document, Oct 12, 2022

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Correia conducted an unannounced annual inspection. LPA Correia identified herself, and was allowed entry to the facility by Licensee Chona Simsuangco. LPA conducted a tour of the facility, accompanied by Licensee Simsuangco, to ensure compliance with the Department’s Infection Control Policy. LPA provided technical assistant and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan (LIC 808). LPA observed one central entry point for universal entry screening; routine symptom screening initiated at entry for staff and visitors; A sign-in policy enacted for all visitors; Face coverings worn by staff; Hand sanitizer/hand washing stations readily available; A designated visitation area; Emergency agencies’ contact information posted in a location visible to staff and residents; and an adequate supply of PPE (Personal Protective Equipment). Based on observations, the facility is in compliance with and has implemented infection control practices as outlined in its LIC 808. No deficiencies were observed during today's visit. 0 An exit interview was conducted with Licensee Simsuangco to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided. Signature on this form confirms receipt of the reports.the state’s words, verbatim · CDSS document, Aug 18, 2022

Allegation investigated: Licensee interfered with resident's guardianship.

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced complaint visit to deliver a finding regarding the above allegation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Loida Sanga. Administrator Leonardo Simsuangco joined LPA via phone during the visit. The Reporting Party (RP) alleged that Resident #1 (R1) in the past had a guardian [i.e. Person #1 (P1)], and that Licensee removed P1 as R1’s guardian and was obscuring their name and contact information from R1’s medical provider. The Department’s investigation consisted of an unannounced tour of the facility, interviews of relevant residents, staff, and outside sources, and a review of pertinent facility, legal, and hospital records. [CONTINUED ON LIC 9099-C, 1 of 2] Unsubstantiated [CONTINUED FROM LIC 9099] According to the San Diego County Office of the Public Administrator / Public Guardian, R1 is not conserved, but in the past, had a temporary guardian. Their office formally reassessed R1 in 2020, and determined that R1 no longer met criteria for guardianship. CCLD determined that the phone number provided for P1 was correct, by verifying it against multiple outside sources. However, multiple attempts to reach P1 on separate days all led to a non-working telephone number. R1 has lived at the facility since 2020, and their spouse, Resident #2 (R2), has lived at the facility since 2016. By the time frame of the Department’s investigation in September 2021: R1 was cognitively impaired but remained alert and able to express basic opinions in simple sentences, and R2 was oriented to person, place, time, and reality. Staff and outside sources unanimously reported being unable to contact P1, and that P1 had zero involvement with either R1 or R2 during the entirety of their stay at the facility. Interviews with R1, R2, and a credible outside source [Person #2 (P2)] revealed that P1 was a former friend, who R1 no longer trusts nor wishes to associate with. R2 and P2 stated they did not believe that P1 was ever R1’s conservator or guardian, even in the past. Per interview of Licensee: a) at time of R1’s move in, licensee was completely unaware of who P1 was, b) at time of R1’s move in, R1 was ambulatory, able to drive a car, able to manage their own finances, and cognitively independent, and c) much later during R1’s tenure at the facility, R1 revealed to licensee that P1 was a temporary guardian who was assigned to R1 following an acute fall which R1 suffered at their private residence before move-in to the facility, and that P1 was no longer R1’s guardian. Interviews, admissions agreements, and facility records corroborated: a) R1 was the payee and responsible party for R2 during the many years R2 resided at the facility, b) R1 was their own payee and responsible party when they later moved in, and c) Until around March 2021, R1 had been correctly paying rent to the facility for many years. Licensee thus had no reason to suspect R1 should have a guardian or responsible party other than themselves. [CONTINUED ON LIC 9099-C, 2 of 2] [CONTINUED FROM LIC 9099-C, 1 of 2] According to multiple interviews, by September 2021, R1 and R2 had run out of paper checks, had run low on funds, and were nearly six months behind on rent to the facility. Licensee stated he was committed to the welfare of R1 and R2 and was emotionally unwilling to pursue eviction. On August 24, 2021, Licensee made his facility available as a meeting place so that R2 could designate P2 as their Power of Attorney (POA), and to have said document notarized on-site. This action benefited both R2 and Licensee. [R1 still did not have a POA as of that date.] Based on records and interviews, a preponderance of evidence does not exist to support the allegation that Licensee interfered with resident’s guardianship. The allegation is therefore unsubstantiated. An exit interview was conducted with Sanga and Simsuangco. A copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided to the administrator via E-mail.the state’s words, verbatim · CDSS document, Nov 12, 2021 · control 08-AS-20210902152020

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Required 1 - Year Visit. The facility file was reviewed prior to the visit. LPA was greeted by and identified himself to Caregiver Loida Sanga. LPA then met and discussed the purpose of the visit with Administrator Leonardo Simsuangco. LPA conducted a brief tour of the facility and observed the residents in care. In accordance with the Department’s Infection Control, LPA provided technical assistance and observed and evaluated the facility's implementation of their COVID-19 Mitigation Plan, to include disinfection, screening protocols, and the use of personal protective equipment. All staff encountered have a current criminal record clearance. No deficiencies were cited on this date. An exit interview was conducted with Simsuangco, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided via E-mail.the state’s words, verbatim · CDSS document, Jul 27, 2021