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HomeMy WebLinkAbout2009-02-10; City Council; 19722 part 1; Receive presentation regarding TERI groupCITY OF CARLSBAD - AGENDA BILL 17 AB# 19,722 MTG. 02/10/09 DEPT. CM Receive Presentation by Bressi Ranch Homeowners Regarding TERI Group Home in Bressi Ranch DEPT. HEAD CITY ATTY. x£$^ CITY MGR. (ju* RECOMMENDED ACTION: Receive a presentation from Bressi Ranch Homeowners regarding a TERI group home being placed in the Bressi Ranch community. ITEM EXPLANATION: The City Council provides an opportunity for citizens and organizations to have an item placed on a City Council Agenda by submitting a letter to the City Manager. Attached is a letter (Exhibit 1), from a group of Bressi Ranch Homeowners requesting that the City Council consider the concerns raised in the letter relating to the TERI group home in Bressi Ranch. FISCAL IMPACT: N/A ENVIRONMENTAL IMPACT: N/A EXHIBITS: 1. Letter from Bressi Ranch Homeowners requesting to present at Council Meeting Dated January 7, 2009 DEPARTMENT CONTACT: Kimberly Dillinger 760-434-2959 kdill@ci.carlsbad.ca.us FOR CITY CLERKS USE ONLY, COMMISSION ACTION: APPROVED D DENIED O CONTINUED n WITHDRAWN D AMENDED O CONTINUED TO DATE SPECIFIC P CONTINUED TO DATE UNKNOWN D RETURNED TO STAFF D OTHER - SEE MINUTES DCouncil received tbe presentation, January?, 2009 Lisa Hildabrand City Manager City of Carlsbad RE: TERI Group Home in Bressi Ranch/Request to be placed on 1/13/09 Agenda FAX: 760-720-9461 Lisa, In follow up to a special meeting between Bressi Ranch Homeowners and pro tem Kulchin and Councilperson Packard on Monday, January 5, 2009 I would like to request that our concern be placed on the City Council Meeting Agenda for January 13, 2009. As per Debbie Fountain this request is required in writing. Please consider this letter our formal request. I have attached a letter drafted, which has already been submitted to Carlsbad City Council on January 6, 2009, as documentation of overall Bressi Ranch Resident's outstanding questions, concerns and recommendations regarding this issue. Respectfully, Bressi Ranch Homeowners and your constituents City of Carlsbad Cc Mayor Lewis pro tem Kulchin Councilperson Packard Councilperson Hall Councilperson Blackburn Carlsbad City Attorney DATE: January 8, 2009 TO: Mayor Lewis, Carlsbad City Council, Carlsbad City Manager, Carlsbad City Attorney FROM: Bressi Ranch Residents SUBJECT: Group home in Bressi Ranch We are appalled to learn that the City of Carlsbad has provided $800,000 (in addition to nearly $600,000 from the federal government) to TERI Inc. to establish a group home on Alverton Drive in Bressi Ranch to serve four, with plans for up to six developmentally disabled men. There are a number of issues with this plan. 1. Wasteful use of taxpayer money: Spending over $1 million of taxpayer money for a group home in an upscale neighborhood is an outrageous use of funds by the city and by a non-profit, charitable organization. TERI could have easily bought two homes in less expensive neighborhoods and served twice as many disabled individuals. Being "fair" to handicapped people who require government financial assistance should not include using government money to buy into an expensive neighborhood far beyond the financial ability of the vast majority of Americans. Although the City says that TERI has a right to purchase a home wherever they wish, we feel that the city has the right and responsibility to conduct cost-benefit and impact analyses before providing the funds. Taxpayers are rightfully angry when they see their tax dollars spent in this manner. 2. Inappropriate site: Bressi Ranch was designed as a high-density, pedestrian- and family-friendly neighborhood with strict CC&Rs. The area of Bressi Ranch where the home is being placed includes the densest of the various single-family-home neighborhoods. Children commonly play on the sidewalks and in the streets. There is an expectation of safety. Given the nature of the neighborhood, the proposed site is inappropriate for several reasons: a. Safety of children & others: TERI serves a broad range of clients who can be a danger to themselves and others, and therefore proposes to put up a front-yard fence to prevent their clients from wandering. However, this is in violation of our CC&Rs and would certainly diminish the ambience of the neighborhood. Most TERI group homes are in more rural areas without CC&Rs, where they are separated by more land, where putting up fences is more typical, and where neighborhood children aren't playing directly in front of the home. The particular home purchased by TERI is on the perimeter of the neighborhood and has a larger lot; however, the interior lots in that area are very small and children frequently play in the front yards and streets. One has to question why TERI wishes to place the home here at all. b. Greater negative impact on home values than in a rural area: Placing this type of group home in a high-density, expensive neighborhood has a far greater negative impact on home values than placing it in a rural neighborhood with large lots and no standardized requirements of construction, landscaping, and maintenance. Two home sales on the same street have already fallen through because of this, and at least one other would have, but it was too late. Bressi Ranch residents paid more to buy into this neighborhood because they believed the stricter CC&Rs and Homeowners Association would help protect their home values, as well as provide a safe environment for their families. Yet we're told that the group home is essentially exempt from these requirements. We have been placed in the catch-22 situation of having a large fence surrounding the property, thus violating the CC&Rs and the ambiance of the community, or allowing group home residents to roam freely around the neighborhood despite the fact that they are supposed to be fenced in. Once again, these problems wouldn't exist if the home were simply placed in a rural large-lot area of town. 3. Failure to protect residents of Bressi Ranch: The city government failed in its most basic responsibility: to protect residents. Our Homeowners Association was not even informed until after the home had closed escrow. The city accepted verbal promises of light-impact use of the property ("only high functioning autistic individuals") yet required nothing in writing. In fact, the permits granted to TERI allow even the highest risk clients to be housed in this group home. Although residents of the group home cannot be assumed to be criminals or sex offenders, there is a reason they 're not allowed freedom of movement. We doubt that it is solely for their own protection. What do we want? We want our children (and ourselves) to be safe, our tax money to be spent wisely, and our home values to be protected to the extent reasonably possible. This means the home cannot be located within Bressi Ranch or other similar neighborhoods. We would like the city to do everything within its power to cause TERI to use the money wisely and build/buy into a rural less-expensive location. If the above were truly impossible, we would like the city to do everything within its power to assure that TERI is legally required (rather than just giving verbal assurances) to limit the residents of this home to those with no proclivity toward criminal or sexual offenses, and no indication that they might be dangerous to others. If this requirement is not possible, then they should be legally required to stay away from all the park areas and the clubhouse/pool facilities at all times. Failure to abide by such legal requirements should be cause for removal of their license to operate the home. This is not about discrimination. Bressi Ranch happily includes a multi-racial, multi-cultural population, affordable housing (condominiums), and soon-to-be-built senior housing and a Boys and Girls Club. It is about public safety, misuse of taxpayer dollars, enforcement of the CC&Rs, and protection of home values in our neighborhood. Carlsbad rightfully prides itself in creating and maintaining a community that is the envy of others. In this instance, however, the City Council really dropped the ball - and the residents of Bressi Ranch are paying the price. AGENDA ITEM # / / c: Mayor February 10, 2009 City Council City Manager City Attorney City Clerk TO: CITY MANAGER FROM: HOUSING AND REDEVELOPMENT DIRECTOR INFORMATION PACKET PROVIDED BYTERI Attached please find five (5) copies of information provided by TERI in response to some of the more recent concerns raised by Bressi Homeowners. Letters of support for the TERI home are also included for review by the City Council. TERI requested that the information be distributed to the City Council prior to the meeting this evening. you, DEBBIE FOUNTAIN Serving individuals with developmental & r;;^ learning disabilities and their families since 1980 :v.33. TRAINING EDUCATION & RESEARCH INSTITUTE 6 MEMO To: Carlsbad City Council Members From: TERI February 9,2009 RE: Licensing & Regulation Information All of TERI's programs are regulated at the federal, state, and local level and internally our standards of care go beyond what is legally required. The agency was founded out of an effort to create a new quality standard in our industry and to serve as a model for other providers. Through tough hiring practices, in-depth training programs, a strong benefit package, and a commitment to the belief that our staff are our greatest resource, we are able to hire and retain highly qualified staff to care for the over 600 individuals with developmental disabilities we serve. B , . , Attached is a list of "deficiencies and plans of correction" that have been issued to TERI by the Department of Health & Human Services for Medicare and Medicaid services. This packet covers the period of 2004 until present for our La Costa home in the City of Carlsbad. This information can be accessed by the public >»»«3 at anytime. t>p-G(•**:' Outside of the examples we have attached covering the past five years, we are aware of only two citations in <£> the 28 year history at our La Costa home. One of these involved and accident where an open van door inadvertently hit a resident while the van was reversing out of the driveway. The second involved a staff who J^Ji was struck by a client, and who instinctively slapped the client in return. The first incident left bruising on the resident and the second resulted in no injury whatsoever. Appropriate disciplinary action was taken, up to and including termination of staff involved. California's ICF/DD-H (Intermediate Care Facilities/Developmentally Disabled - Habilitative) residential programs are closely monitored by both state and federal agencies. These programs are funded through a combination of state and federal monies through the Medicare/Medicaid system. ,ui t•W To qualify for reimbursement, ICF/DD-H programs must be certified and comply with federal standards (Conditions of Participation) in eight areas to include: management; client protections; facility staffing; £Zj active treatment services; client behavior and facility practices; health care services; physical environment; ,J~J and dietetic services. ICF/DD-H facilities are licensed and certified by the Licensing and Certification Division of the California Department of Public Health under Title 22, California Code of Regulations Q-< and Federal W-Tag regulations. Small health facilities are subject to robust oversight and enforcement .- . activities that include an annual CDPH survey visit that averages 3 days in length in addition to other "stand F*2;_^" alone" visits triggered throughout the year by facility-reported events. ICFs/DD-H are required to comply with over 400 federal requirements and a similar number of state licensure requirements. 25 I /* port! o; : :.e; nside Califbrni? 92058 (76 ;' 11 I- :>•'..' ' (760) 721-9872 (fax) - www.teriim c , TERI is also monitored and regulated by the following agencies when opening a residential facility and throughout the existence of the home: California Department of Developmental Services San Diego Regional Center State Council on Developmental Disabilities Adult Protective Services Long-Term Care Ombudsmen Human Rights Committee-Interdisciplinary In a society where statistics of assault, abuse, and other violent crimes are staggering within our "general population", TERI is proud to be a wonderful example of how to treat each other with dignity and kindness. All of our actions at TERI are transparent and a matter of public record. Our long-term history of quality care, and the fact that we have been recognized as being a model program in the State of California, is a testament to our commitment to this, our nation's greatest and most vulnerable minority. Enclosures: Support Letter San Diego Regional Center NC Times Letters to the Editor "Deficiencies and Plans of Correction "— La Costa Residence T-018 P.002/002 F-877FEB-09-09 12:48 FROM-San Diego Regional Canter- Exec. Office 858-575-2873 San Diego Regional Center for the Developmentally Disabled 4355 Ruffin Road, Suite 114, San Diego, California 92123-4307 • (85J5) 576-2996 MEMORANDUM DATE: February 9,2009 TO: Carlsbad City Officials Claude A. Lewis, Mayor Ann J. Kulchin, Mayor Pro Tern Keith Blackburn, Council Member Matt Hall, Council Member Mark Packard, Council Member FROM: Carlos Flores, Executive Director RE: CDBG Development by TERI, Inc. I write in support of the efforts of TERI to develop a place to live for persons with developmental disabilities with CDBG/ Home funding generously provided by the City of Carlsbad. The efforts of a small group of Carlsbad residents to stop this development are reprehensible. Their accusations and reasons for blocking the development are nothing more than not in my back yard (NIMBY) discrimination against one of our community's most vulnerable citizens. For many years TERI has provided quality residential services for persons with developmental disabilities. I am confident that they will continue this tradition of caring, thoughtful service in the City of Carlsbad. As Mayor and City Council your decision to award the funding to TERI shows your humanity and compassion and you are helping people that are in their circumstance through no fault of their own. The San Diego Regional Center has a contract with the State of California to provide service coordination and to fund services for more than 18,000 persons with developmental disabilities in San Diego and Imperial counties. Our vision is that some day all persons with developmental disabilities will be active, contributing members in our communities. This is in contrast to our history when the only services once available for persons with developmental disabilities were in state institutions. On behalf of the Board of Directors and staff of the San Diego Regional Center my sincere appreciation to the Mayor and City Council members of Carlsbad and to TERI for joining us in our vision. 1:\ADMTN\SDAAI\CORRESP\0209TER1SUPPORT.LTR.DOC A Service of San Diego-Tniperial Counties Developmental Services, Inc. Serving Individuals with Developmental Disabilities mm: ruKuivi: uroup nome outcry unwarranted : iNortn county limes - caiirorman rage i or L Print Page &&d, Mews' It&diy Local R&nl Mews • Rj&Uty tte&l NORTH COUNTY TIMES I THE CAUFORNIAN Last modified Friday, January 30, 2009 12:09 AM PST FORUM: Group home outcry unwarranted By DEMISE LAWTON - Poway resident I am writing in response to the very unfortunate and disconcerting events that are transpiring among certain Bressi Ranch residents concerning the TERI home and the four young residents with autism who will soon be moving there. I am first and foremost a mother of an autistic son and a typical daughter, both of whom are now grown. I am also an RN and a member of a community that was, at the time of our moving in (the 1980s), an upwardly mobile new tract community in North County. As a young family, we experienced all types of discrimination and isolation like what is currently going on in Bressi Ranch. Some of it was overt and some thinly veiled. It is born of ignorance and closed minds that refuse to see people with developmental disabilities as opportunities for them and their children to grow, learn and work alongside each other to make their neighborhoods welcoming and well-rounded places where everyone flourishes. I find it odd that they have charged that TERI bought this house "in secret" and intended to fool the residents into accepting their clients as members of the community. I've got news for them —- they are members of the community, and no amount of whining and stomping of feet will change that. These young men deserve to live in a nice home of their choosing, just like anyone else. There is no reason that they have to choose a home in a "lesser community of $500,000 homes" — their words, not mine. TERI is an excellent organization that takes superior care of their clients and their homes, and they do not owe anyone notice of their decision to plant a family there or anywhere else. They have proven over many years that they and their clients make exceptional neighbors who add and do not subtract from the community by their presence. Our son is now 24 and lives very successfully in a TERI home. The neighborhood folks love him and his "second family," and see their presence as an opportunity, not a liability. That goes double for the extended community as well. These guys are loved, appreciated and guided by everyone who takes time to get to know them. As to the mother of the 4-year-old with autism who had her heart broken at the public meeting, my advice to you is to cease trying to fit in with people who don't want to take the time to truly get to know your family. There are many more individuals who would welcome the opportunity to be a part of your son's life and who will, in turn, also enrich yours. Choose to focus on them. Print: FORUM: Group home outcry unwarranted : JNorth County limes - uaiitorman rage L or L Our son, who struggled as a youngster, is doing great — he contributes to society and is a happy, well-adjusted individual who, like everyone, needs some help to be the best he can be. Unfortunately, many of the families in our community cannot yet say that about their teenagers and young adults who are having a very tough time navigating the real world, in large part, I suspect, due to spoiled, immature behavior, fearmongering, snobbery and other unfortunate actions that have been exhibited by their parents. Denise Lawton lives in Poway. rnm/flrtir1es/900Q/01 /30/nnininn/commentarv/75e1875bbe25bb062882... 2/2/2009 1-25-09 Group home has been great help to son My son, Christopher, is 49 years old. He has Down syndrome. For the past 28 years, he has lived in the TERI Inc. La Costa home in Carlsbad. It has been a heartwarming experience for him and for his family because he is happy and well cared for. In this carefully structured environment, he has found acceptance, a purpose to life, a way to contribute to society and a healthy lifestyle. He has friends with whom he can share duties, living experiences and fun. He has a staff family he can look up to as mentors and counselors. Christopher's TERI Inc. home has given him the gift of living up to his capacity.... I am not only indebted to TERI Inc., but extremely impressed by and respectful of what TERI Inc. has done, not only for Christopher, but for all the young adults they have housed and loved. By lovingly assisting these individuals to fit into a neighborhood community, we are affording them the gift of not being dependent on society and taxpayers to support them. We are enhancing lives in a positive way and joining as real neighbors to look beyond prejudice to a better overall community of responsible adults. Ruth Johnson La Jolla North County Times Letters to the Editor Different is not bad Hie TERI foe. group home and those like it are gifts to the families of these young people and to the communi- ties they grace with their presence, They offer people a chance to live in a social and accepting environment while continuing to hone their life skiiis. They wont be speeding through your neighborhood, throwing loud parties or dis- respecting their elders. Give them a chance, and you will find them delightful. To those in Bressi Ranch who think they live in someself-proclaimed elite commu- nity ("Bressi Ranch grouphome proposal causes contro- versy," Jan. 6), educate your- selves. Currently, 1.5 million Americans have some form of an autism spectrum disorder; autism is the fastest-growing neurodevelopmental condi- tion; 1 child in 150 births is affected by autism. Ibis disor- der and its ramifications are not going away. Intelligent people learn that differences are not bad, and they teach that lesson to their children, thereby creat- ing a population that ceases to fear and learns accept- ance, an acceptance that iscritical in today's society. The Dove Library current- ly has a display of books about autism. That library is not far from Bressi Ranch. Please take advantage of the opportunity to be educated.mmivnvn? «r AIWVI Group home a good opportunity for neighborhood Re: "Bressi -Ranch grouphome-proposal causes con- troversy,"1 Jan. 6: The resi- dents of Bressi Ranch shouldgrow up and put aside their Not In My Back Yard atti- tudes. Hie house being con- sidered for purchase by TERI Inc. is slated to house and provide supervision forup to six mentally disabled men. ( This seems to have put a lot of $700k-to-$l mil- lion-plus homeowners in the mood for a lawsuit. The Bressi owners arescared the group home resi- dents wiH run loose and ter- rorize- their children and neighborhood; they fear their "nicely appointed homes and pedestrian-friend- ly streets" will be changed. Maybe so, but maybe in goodways. . • Perhaps those so opposed to the home can make an ef • fort to meet and know the res-iA*~.t*> ——u * -, ^ .—JC- — I n~r~ T¥^H»rt^*JM^and include them and their caretakersjn thecoi&nunity. Perhaps they and the neighborhood children might learn valuable lessons about charity, acceptance, toler- ance, kindness, compassion and caring. Fear is all about the unknown. A suggestion to those op- posed: First, be very grateful for your mental and physical well-being and that of your children; then, be willing to 0+!,..«._* 1J_ J • »* portum'ty to learn somethingvaluable.CARrvT.fi sKBTiKus. 1-22-09 Exposure to 'different1 people teaches acceptance Re: "Bressi Ranch group home proposal causes controversy." Jan.Jj: I am an employee of Vons grocery store and have had the pleasure of working with many of our special-needs citizens over the years. Some of our special-needs employees do reside, or in the past have resided, in group homes. It has been a great honor to work with these people, and I have had many customers thank us for employing them and giving them a chance. Believe me when I tell you that they have enriched my life in ways I never knew possible. I have never once felt threatened or fearful. I only feel sheer joy when I can make an autistic person giggle from the inside out. I cannot imagine a better opportunity to teach young kids acceptance, tolerance and patience than to expose them to people who are "different." My own children absolutely love the special needs citizens that I work with and mentor. Why? Because they have been exposed to them and have learned how to communicate with them. I have always felt that if every citizen in our community could just bend a little bit, room and a job and a home for these very special, gentle and truly sweet human Amy Laskye-Caplas Oceanside Bressi Ranch residents should be ashamed It is dismaying to see such blatant and unfounded dis- crimination coming out of Bressi Ranch in regards to the group care home that TERI Inc. is starting there ("Young autistic men may move into Bressi Ranch home,* Jan. 11). I have a son with special needs, and when my wife and I are dead and gone, he will probably need to be placed in a group home similar to the one proposed byTERI. Group homes are found everywhere in our state aridare regulated by state law. The unfair bias shown by the citizens of Bressi Ranch who feel that their neighborhood is too good for people with special needs is, frankly, ugly.Bravo to TERI Inc., the City Housing Department and to HUD for coming up with the money to house those with special needs. To the Bressi Ranchers who feel so special that they don't want anyone with spe- cial needs in their neighbor- hood, you should be ashamed. • JERRY ABSHIER Carlsbad there would be beings Residents'fears of group home unfounded I was recently saddened by comments I heard on televi- sion news and read in the pa- per on Jan. 6 made by resi- dents who Iwe in Bressi Ranch in protest of a group home for mentally disabled young men ("Bressi Ranch group home proposal causes controversy")-I'm happy their children are "normal." We have a son born with cerebral palsy, and I want them to know we con- sider him a blessing! t Comments (include a fear the residents -would: • "Escape their facility." They are not incarcerated; it'll be their home,-and they win come and go to their jobsand activities just Eke you. • "Hurt neighborhood children." Go meet them. You'll find them to be gentle, loving people who are muchless likely to "hurt" your chit dren than the average popu- lation.• "Engage in inappropri- ate behavior." Really? Td be more concerned about my son being an altar boy! For many years, we coached a Special Olympic tennis team, of wonderful people who have a disability; they became our friends. "Normal" people all over theworld volunteer for SO events. Maybe some of you in Bressi Ranch could; you'd learn a lot about this special population. Equality for all, but not for the mentally disabled? BrVRTT-RTA VATVF HISP. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 11/14/2003 FORM APPROVED OMB NO. 008-0391 STATEMENT OF DEFICIENCIES (XI) PROVTDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVF I AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUILDrNG COMPLETED 05G952 B. WING 11/0'7/20V3 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4)ID PREFIX TAG WOOO W325 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) INITIAL COMMENTS The following reflects the findings of the Department of Health Services during a Fundamental survey. Representing the Department of Health Services: Aty Knooren, HFEN. The census at the time of the survey was 6 clients. The sample size was 3 clients. 482.460(a)(3)(iii) PHYSICIAN SERVICES The facility must provide or obtain annual physical examinations of each client that at a rninimum includes routine screening laboratory examinations as determined necessary by the physician. This Standard is not met as evidenced by: Based on interview and record review the facility failed to have laboratory tests/results in the clients' records for 2 (1, 2) of 3 sampled clients. The findings include: 1 . According to the Client Identification and Emergency Information sheet, Client 1 was admitted to the facility on 1 1/2/87 with diagnoses that included severe mental retardation. Per the Physician's Order Form, Client 1 had an order since 8/20/97 to have an annual urinalysis (u/a) done. Interview with the nurse on 1 1/1/03 indicated that she would look for the results however, there was no evidence of an annual u/a available in the record. 2. According to the Client Identification and Emergency Information sheet Client 2 was admitted S^\ (V ID PREFIX TAG WOOO W325 • PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) RN staff :>overlooked his UA. New system to double check labs has been put in place to ensure compliance. The phenobar bitol levels have been and UA's have been done. RN responsible. (X5) COMPLETE 3ATE l?-3-0' LABORATORY DIRECTOR'S Ol^RO/IpER/STjPPLlfeR REPRESENTATIVE'S SIGNATURE C TITLE (X6) 3ATE Any defiofejifcystatement ending with an asterisk (*) denotes a itejiefency which the institution may be excused from correcting providing it is determined that othc: safeguards provide sufficient protection to the patients. ExcepLftr nursing homes, the findings above are disclosable 90 days following the date of survey whether )r not a plan of ejection is provided. For nursing homes, the above fujdjngs and plans of correction are disclosable 14 days following the date these documents are made ivailable to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. FORM CMS-2567(02-99)U75F11 If continuation sl:eet I of 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Prmted: Y I/14/2003 • FORM APPROVED OMB NO. 09*18-0391 STATEMENT OF DEFICIENCIES (XI) PROVIDER/SUPPLEER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUTLDING COMPLETED 05G952 awING 11/0 7/20«>3 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4)ro PREFIX TAG W325 W352 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 1 to the facility on 5/8/85 with diagnoses that included profound mental retardation. Per the Physician's Order Form, Client 2 had an order since 8/20/97 to have a phenobarbitol level done every six months. The last available phenobarbitol level in the record was dated 3/6/03. The next level that would have been due in 6 months, for September was not available in the clinical record. Interview with the nurse on 1 1/7/03 indicated that it was most likely done but just not filed. 483.460(f)(2) COMPREHENSIVE DENTAL DIAGNOSTIC SERVICE Comprehensive dental diagnostic services include periodic examination and diagnosis performed at least annually. This Standard is not met as evidenced by: Based on interview and record review 2 (2, 3) of 3 sampled clients did not receive their annual dental services. The findings include: 1 . According to the Client Identification and Emergency Information sheet, Client 2 was admitted to the facility on 5/8/85 with diagnoses that included profound mental retardation. His last annual dental exam on record was documented as 4/25/02. 2. According to the Client Identification and Emergency Information sheet, Client 3 was admitted to the facility on 2/10/95 with diagnoses that included severe mental retardation. His last annual dental exam on record was documented as 4/18/02. ID PREFIX TAG W325 W352 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY Not being able to get denta services for these clients needing outpatient services continue to be difficult. It is due to inavailability of facilities in the area. We are done everything we can to facilitate dental treatment and win continue pursuing . (X5) COMPLETE DATE 1 12-3-03 FORM CMS-2567(02-99)U75F11 If continuation ;Keet 2 of 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 11/14/2003 FORM API-ROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (XI) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVET AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUILDING COMPLETED 05G952 B. WING 11/0'7/200 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4)ID PREFIX TAG W352 W389 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 2 The nurse was interviewed on 1 1/7/03 at 1:00 P.M. According to the nurse there was only one available dentist in the area that takes MediCal patients. She stated that the facility could not schedule the appointments early with the dentist because it was the dental clinic that informed the facility of the available openings. According to the nurse the clients that were over due to be seen would be scheduled at the earliest available opening. 483.460(m)(l)(ii) DRUG LABELING Labeling for drugs and biologicals must include the appropriate accessory and cautionary instructions, as well as the expiration date, if applicable. This Standard is not met as evidenced by: Based on observation and interview the expiration date was covered up on three drugs. The findings include: The medication storage review was conducted on 1 1/5/03 at 3:00 P.M. with the Assistant Director of Residential Services (ADRS) and the Qualified Mental Retardation Professional (QMRP). Three medications, debrox, docusate sodium and a vitamin supplement did not have an expiration date on the label and the expiration date on the bottle was covered up with the medication label. The ADRS was interviewed during the inspection on 1 1/5/03. She agreed that there was no visible expiration dates on the medications. ID PREFIX TAG W352 W389 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Alternate funding options. This will be documented in clients charts. RN responsible. The pharmacy has been con- tacted and made aware of error. A new plan is in place to circle expiration dates on bottles & boxes. Also, they will double chec to ensure that both dates natch . RN responsible. (X5) COMPLETE DATE 11-24-0: Ll-24-0: FORM CMS-2567(02-99)U75F11 If continuation sUet 3 of 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 11/: 4/2003 FORM APPROVED OMB NO. 09:; 8-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4)ID PREFIX TAG W390 W390 W454 (XI) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B.WING (X3) DATE SURVEY COMPLETED 11/07/200? STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 3 483.460(m)(2)(i) DRUG LABELING The facility must remove from use outdated drugs. This Standard is not met as evidenced by: Based on observation and interview the facility failed to remove outdated drugs from the medication area. The findings include: The medication storage review was conducted on 1 1/5/03 at 3:00 P.M. with the Assistant Director of Residential Services (ADRS) and the Qualified Mental Retardation Professional (QMRP). A box of claritin was labeled with an expiration date of 12/04. However, the pills inside the box had an expiration date of 10/03. The RN was interviewed on 1 1/5/03. She stated that the outdated medication was not removed from stock because she had only looked at the label on the box when checking for expired medications and did not notice the expired date on the back of the pill packaging. 483.470(1)(1) INFECTION CONTROL The facility must provide a sanitary environment to avoid sources and transmission of infections. This Standard is not met as evidenced by: Based on observation and interview the facility failed to avoid a source for the transmission of infection. The findings include: The medication administration review was conducted ID PREFIX TAG W390 W390 W454 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) See response to W389. ;xs) CO) 1PLETE HATE FORM CMS-2567(02-99)U75F11 If continuation ;.lieet 4 of 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 11/14/2003 FORM APPROVED OMB NO. 093J-Q391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4)ID PREFIX TAG W454 (XI) PROVTDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION IDENTIFICATION NUMBER: A BUILDING 05G952 B. WING STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 4 on 1 1/4/03 at 8 P.M. The direct care staff (DCS) dispensing the medications applied a first aid treatment of triple antibiotic ointment to a 1 cm open area on the unsampled (5)client's arm. The first aid stock antibiotic ointment tube tip touched the client's wound thereby contaminating it and the DCS returned the first aid ointment to stock The DCS was interviewed after returning the medication to stock and stated that he forgot that it was a house stock medication. The Assistant Director of Residential Services (ADRS) was present during the medication pass and she was also interviewed. She stated that the stock antibiotic ointment should have been applied by placing the antibiotic ointment on a Qtip or placed on a gauze so that the tip of the tube would not touch the client's wound and be contaminated. ID PREFIX TAG W454 (X3) DATE SURVEY COMPLETED 11/07/200H PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Staff error. The staff naking the error -has been retrained on proper 1st Aid procedures . IN responsible. X5) COMLETE I 'ATE 11-3-03 FORM CMS-2567(02-99)U75F1:If continuation s-ieet 5 of 5 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/200-! FORM APPROVES OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG WOOD W111 ^LABOR^TO r ( / (X1) PROVTOER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION IDENTIFICATION NUMBER:A. BUILDING 05G952 aWING STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) INITIAL COMMENTS The following reflects the findings of the Department of Health Services during a FUNDAMENTAL survey visit. Representing the Department of Health Services: Patricia Horn-Seuferer, HFEN; and, Kathleen Gomez, HFEN. The facility census at the time of the survey was 6 clients. The sample size was 3 clients. 483.410(c)(1) CLIENT RECORDS The facility must develop and maintain a recordkeeping system that documents the client's health care, active treatment, social information, and protection of the client's rights. This STANDARD is not met as evidenced by: Based on interview,and record review, the facility failed to develop and maintain a complete recordkeeping system that documented the clients' health care,for 3 of 3 sampled clients (1, 2, 3); and, 1 client added to the sample (6). As a result, medication administration records, nursing summaries, and data collection sheets were not available for review.Physician's orders for the use of Gentamicin (antibiotic) eye drops and Augmentin (antibiotic), were not included in the record; and, discontinued physician's orders remained on the physician^s recapitulation orders. The findings include: 1. On 12/08/04, the clients medical records were reviewed. The f DIRECTOR'S/OR PhoMIB'ibuJml ^medication administration ID PREFIX TAG wooo W111 (X3) DATE SURVEY COMPLETED 12/09/2004 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) ER/SUPPLIER REPRESENTATIVE'S SIGNATURE _ TITLE (XS) COMPLETION DATE l/<fj//\ luT (I //Ujs Any deficiency statement ending with an asterisk (*) denbtes a deficiency which the institution mavfce excused from correcting providim it is determined that other safes lards provide sufficient protection to the patents. (See instructions.) Except for nurslrTg homes, the findings stated above 4re disclosable 90 days following trie date of survey whether or not a plan of ejection is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are died, an approved plan of correction is requisite to continued program participation. FORM CMS-2567(02-99) Previous Versions Obsolete Fuonl in- M7MMH DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/200 FORM APPROVE! OMB NO. 0938-039 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) <X5) COMPLETION DATE W111 Continued From page 1 records (MARs), nursing summaries, and data collection sheets for the months of October and November 2004 for Client 1, Client 2, and Client 3, were not included in the record and were not available for review. The Qualified Mental Retardation Professional (QMRP 2) stated on 12/08/04 at 12:30 P.M., that the documents should have been included in the record and that they were probably with papers that were yet to be filed. She stated that it was the duty of the licensed nurse (LN) to file the MARs and nursing summaries in the record. The LN was interviewed on 12/08/04 at 12:40 P.M. via telephone but was unable to provide the missing documentation. 2. During the medication pass on 12/07/04 at 7:20 A.M., Direct Care Staff (DCS) 1 was observed administering eye drops and oral Augmentin to Client 6. When the administered medications were reconciled the following day, 12/08/04, at 9:30 A.M., there was no written physician's order located in the medical record, for the use of the eye drops and/or the oral antibiotic. The LN was interviewed on 12/08/04 at 12:40 via telephone. She stated that she knew the original order existed because it was needed to obtain the prescription from the pharmacist; however, she was unable to provide a copy of the order. 3. Client 2 was admitted to the facility on 9/07/82, with diagnoses that included moderate mental retardation and congenital encephalopathy (dysfunction of the brain), according to the face W111 RN Error 1) The MARS had not been filed in the chart. Atta are the MARS for Oct/Nov Attachments #1,2,3 RN responsible/ QMRP to monitor :hed !004. 2) RN Error Order was not copied before sending to pharmacy. Attached is a copy of ord£r, Attachment #4RN responsible/QMRP to monitor RN. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 2 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W111 W124 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETED 05G952 BWING-12/09/2004 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 2 sheet. Client 2<;,s medical record was reviewed on 12/08/04. According to the most recent physician's monthly recapitulation orders, dated September 2004, the following orders had been discontinued yet they continued to recur on the monthly orders: a. 'Bactroban Ointment 2%, apply to affected area three times a day for one week.,;. The original order was dated 12/31/03, and should have been discontinued one week later on 1/07/04. b. 'Diazepam 2 mg (milligrams), take one tablet before surgery for anxiety, i The original order was dated 4/1 4/04,and should have been discontinued on 4/14/04. The licensed nurse was interviewed via telephone on 12/09/04 at 12:00 P.M. She stated she received the physician's recapitulation orders on a quarterly basis. She reviewed the orders for accuracy. She acknowledged she did make a notation on the medications orders to indicate the medications had been discontinued. She acknowledged the medications should have been removed from the physician's recapitulation orders to prevent the potential for medication errors. 483.420(a)(2) PROTECTION OF CLIENTS RIGHTS The facility must ensure the rights of all clients. Therefore the facility must inform each client, parent (if the client is a minor), or legal guardian, of the client's medical condition, developmental and behavioral status, attendant risks of treatment, and of the right to refuse treatment. ID PREFIX TAG W11'1 W124 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) RN Error 3a.) Orders will be reviewe for recapitulation by RN in a timely manner. RN responsible/QMRP to moni 3b.) See response to a. (X5) COMPLETION DATE 1/1/05 d tor FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 3 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA BUILDING 05G952 BWING 12/09/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W124 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 3 This STANDARD is not met as evidenced by: Based on observation, interview, and record review, the facility failed to obtain informed consents for preoperative medications, for 1 of 3 sampled clients (2); the facility failed to obtain informed consents prior to surgical procedures, for 1 of 3 sampled clients (2); and, the facility failed to obtain consents for general anesthesia, for 2 of 3 sampled clients (1, 3). The findings include: 1a. Client 2 was observed on 12/06/04, between 4:05 P.M. and 8:00 P.M. He communicated through signs, gestures, and use of a picture book. He ambulated independently. He was independent with most of his activities of daily living such as eating, dressing, and personal hygiene. Client 2{,s medical record was reviewed on 12/08/04. Client 2 was admitted to the facility on 9/07/82, with diagnoses that included moderate mental retardation and congenital encephalopathy (dysfunction of the brain), according to the face sheet. According to conservatorship papers, the client was conserved by a State advocacy agency. According to a prescription, dated 4/08/04, the client was to receive Valium 2 milligrams (mg) one tablet before a surgical procedure. According to the preoperative instruction form, the client was scheduled for the surgical procedure on 5/13/04. The medical record did not contain a consent form to grant authorization for the use of the preoperative medication ID PREFIX TAG W124 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 1a. RN Error RN failed to file copy of consent in chart. Attachme #5 - RN will ensure that co of consents are put in char in a timely manner. RN responsible/ QMRP to monitor (XS) COMPLETION DATE 1 /1 5/051 / • — ' / \J *J nt pies FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 4 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVEP OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (XI) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWING 12/09/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE . . ^^ . . ,„, ,«r- 6433 FLAMENCO STREETLA COSTA HOUSE CARLSBAD, CA 92008 (X4)ID PREFIX TAG W124 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 4 The licensed nurse was interviewed via telephone on 12/08/04 at 9:10 A.M. She stated she did not contact the clients conservator to obtain consent for the preoperative medication. 1b. The surgical consent form indicated the client was to have an excision of basal cell carcinomas from the left jaw and the left temple on 5/13/04. There was no signature on the form to indicate whether the client, the conservator, or some other party granted authorization for the procedure. The licensed nurse was interviewed via telephone on 12/08/04 at 9:10 A.M. She stated the dermatologists office contacted the clients conservator to obtained consent for the surgical procedure. She stated she did not know that she was required to advocate for the client to verify that the appropriate party signed the consent. She stated she never saw the consent form and did not obtain a copy of the consent for the clients medical record. 2. On 12/08/04 at 10:00 A.M., review of Client 1's record revealed that the client underwent dental procedures under general anesthesia on 7/06/04. There was no documentation found in the record that an informed consent was obtained prior to the use of general anesthesia. 3. On 12/08/04 at 12:15 P.M., review of Client 3's record revealed that the client underwent dental procedures under general anesthesia on 1 1/04/04. There was no documentation found in the record that an informed consent was obtained prior to the use of general anesthesia. QMRP 2 stated in an interview on 12/08/04 at 12:30 P.M., that informed consents should have ID PREFIX TAG W124 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 1b. See response to 1a. 2. RN Error RN failed to get the report for services from the dentist. See attachment #(. RN responsible/QMRP to mon: 3. See response to #2 See attachment #7 (X5) COMPLETION DATE 1/15/05 1/5/05 tor. 1/5/05 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 5 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/200 FORM APPROVE! OMB NO. 0938-Q3Q STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:. 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE W124 W125 Continued From page 5 been obtained and included in the clinical record. 483.420(a)(3) PROTECTION OF CLIENTS RIGHTS The facility must ensure the rights of all clients. Therefore, the facility must allow and encourage individual clients to exercise their rights as clients of the facility, and as citizens of the United States, including the right to file complaints, and the right to due process. This STANDARD is not met as evidenced by: Based on observation, interview, and record review, the facility failed to obtain consents for the use of a door alarm for 3 of 3 sampled clients (1, 2, 3) and 3 clients added to the sample (4, 5, 6) and the facility failed to actively pursue conservatorship for 2 of 3 sampled clients (1, 3). The findings include: 1. Client 3 was observed on 12/08/04 between 4:05 P.M. and 8:00 P.M. He was nonverbal and communicated through signs and gestures. He ambulated independently. He was independent with most of his activities of daily living such as eating, dressing, and personal hygiene. A door chime was observed secured to the outside of his bedroom door. A key hung from a chain and was also secured to the outside of the bedroom door. The Director of Residential Services was interviewed on 12/07/04 at 9:20 A.M. regarding the door alarm. She stated the client had a history of leaving the facility unescorted. The alarm was used to monitor the clients whereabouts during the night when everyone was W124 W125 Staff Error 1. The alarm has been 12/11/ removed from client 3's bedroom door. If we reinstall alarm, we will take to HR committee for approval and get alarm consents from parents. QMRP responsible for monitoring FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 6 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 B'WlNG 12/0,9/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W125 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 6 asleep. She stated that the client no longer left the facility unescorted, therefore the alarm was no longer set at night. She stated the door alarm remained on the door as a deterrent. On 12/08/04 at 7:35 A.M., the door alarm sounded as Client 3 exited his bedroom door. DCS 4 turned off the alarm. Client 3(,s medical record was reviewed on 12/08/04. Client 3 was admitted to the facility on 5/03/85 with a diagnosis of profound mental retardation according to the face sheet. The behavior plan, dated 8/13/04, identified the clients target behaviors as, £ Wandering to seek items to tear: This includes leaving the group in a building, wandering outside a building, or leaving the group in a public area.,*. The behavior plan interventions did not include the use of the bedroom door alarm. In addition, the medical record did not contain a written consent for the use of the door alarm. Review of Clients 1 , 2, 4, 5, and 6 medical records revealed that there were also no consents for the use of the door alarm. Direct Care Staff (DCS) 1 was interviewed on 12/08/04 at 3:30 P.M. She stated she worked the previous evening with a DCS that was unfamiliar with the house routine. She stated he must have set the alarm when he prepared the client for bed. She stated the alarm was not suppose to be set at night and had not been utilized for the past two months, since she was employed as the overnight staff. Qualified Mental Retardation Professional (QMRP) 2 was interviewed on 12/08/04 at 3:30 ID PREFIX TAG W125 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (XS) COMPLETION DATE FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 7 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/200- FORM APPROVE! OMB NO. 0938-039' STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5> COMPLETION DATE W125 Continued From page 7 P.M. She stated she had not obtained informed consents from all of the clients for the use of a door alarm on Client 3£s bedroom door. She stated the use of the door alarm was discontinued more than one year prior and the door alarm was, iNot suppose to be on.,-. She stated she had attempted to remove the alarm herself, but was unable to do so. She requested maintenance to remove the alarm a few months back, however they had yet to remove the alarm. 2a. Client 1 was an unconserved female admitted to the facility on 11/2/87 with diagnoses that included severe mental retardation per the face sheet. The same face sheet indicated that Client 1 had a brother who lived out of state who was listed as the emergency contact. Client 1 was observed on 12/6/04 between 4:00 P.M. and 8:00 P.M. She ambulated independently and communicated with 4-5 word phrases. The client required frequent assistance and cueing from staff in regard to all of her activities of daily living. On 12/8/04 Client 1's record was reviewed. There was no documentation found in the record that indicated the facility actively pursued conservatorship for Client 1 since the last letter was written to the brother by the Qualified Mental Retardation Professional (QMRP) 1 on 1/15/03. QMRP 1 was interviewed on 12/8/04 at 12:15 P.M. She acknowledged that no recent attempt was made to pursue conservatorship for Client 1. 2b. Client 3 was an unconserved male who was admitted to the facility on 5/3/85 with diagnoses that included profound mental retardation per the W125 2a. Unable to pursue conservatorship due to her brother lives out of state and changed his address and phone number without notifying us of the changes Will discuss with referral representative to see if assist in locating the brotiher QMRP responsible. 12/11/0 she center can FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 8 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. Q938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED 05G952 B WING 12/0 9/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W125 W130 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 8 face sheet. Client 1's father was listed on the face sheet as the emergency contact. Client 3 was observed on 12/6/04 between 4:00 P.M. and 8:00 P.M. The client was non-verbal and communicated with signs and gestures. Client 3 ambulated independently and required verbal prompting from staff for all of his activities of daily living. On 12/8/04 Client 3's record was reviewed. There was no documentation found in the record that indicated the facility actively pursued conservatorship for Client 3 since the last letter was written to the father by the Qualified Mental Retardation Professional (QMRP) 1 on 9/19/03. QMRP 1 was interviewed on 12/8/04 at 12:15 P.M. She acknowledged that no recent attempt was made to pursue conservatorship for Client 3. 483.420(a)(7) PROTECTION OF CLIENTS RIGHTS The facility must ensure the rights of all clients. Therefore, the facility must ensure privacy during treatment and care of personal needs. This STANDARD is not met as evidenced by: Based on observation and interview, the facility failed to ensure that, 1 of 3 sampled clients (2); and, 2 of 3 clients added to the sample (4, 5), were provided with privacy while receiving treatments. The findings include: 1. On 12/07/04 at 7:30 A.M., Client 4 was observed in the kitchen area being directed by ID PREFIX TAG W125 W130 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) /*/\\J)j^dO$trtTZ^ li "1* /?^Y\UM^- v2$J^ ^vi^-^lif^ VLA ft?iA/)/u~K (Ju/v(~/ $~~^-*%(J!QS'TO tl/flAJirf'S " ^^'^ " ivv^s /n ' ' Q< hv \C4 (i^Q^i^^^^^^ 1 . Staff Errors Staff are trained to apply topicals in privacy (bedroon bathrooms). Staff will be in-serviced on privacy issues. RN responsible/ QMRP to moi (X5) COMPLETION DATE /3 \T^ > 2/11/04 s, itor. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 9 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/20C FORM APPROVE OMB NO. 0938-039 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (XS) COMPLETION DATE W130 W254 Continued From page 9 staff to apply moisturizing cream to his hands and face. When asked to apply the cream to his face, he appeared embarrassed and looked around the room at other clients and staff who were watching. Client 4 refused to apply the cream. At 8:25 A.M., Client 4 was once again asked to apply the cream to his face while in the kitchen area and in front of staff and peers. The client was observed quickly applying the cream to his cheeks. 2. On 12/07/04 at 7:45 A.M., Client 5 was observed in the kitchen area being directed by staff to remove her shoes and socks to apply moisturizing cream to her feet, knees and arms. Several other clients and staff were in the area at the same time and watched Client 5 as she applied the cream. 3. On 12/07/04 at 8:20 A.M., Client 2 was observed in the kitchen area being directed by staff to remove his shoes and socks to apply moisturizing cream to his feet. Client 2 did as he was instructed to do while other clients and staff stood around and watched. Direct Care Staff (DCS) 1 was interviewed on 12/08/04, at 9:30 A.M. She stated that she routinely completed treatments in the kitchen area and was not aware that the clients should be provided with privacy. She said that she received her training from a licensed nurse and that was the way she was taught. 483.440(e)(2) PROGRAM DOCUMENTATION The facility must document significant events that contribute to an overall understanding of the W130 2. See response to #1 2/11/04 3. See response to 2/11/04 W254 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 10 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWING 12/0 9/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREETLA COSTA HOUSEwuoc CARLSBAD, CA 92008 (X4) ID PREFIX TAG W254 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 10 client's ongoing level and quality of functioning. This STANDARD is not met as evidenced by: Based on observation, interview and record review, the facility failed to document a newly displayed behavior, for 1 of 3 sampled clients (1). The findings include: On 12/06/04 at 4:10 P.M., Client 1 was observed to open the bathroom door while she was sitting exposed on the toilet. She was asked by staff to close the door while in the bathroom. At 4:15 P.M. and at 4:30 P.M., she repeated the behavior and was redirected by staff. On 12/07/04 at 6:15 A.M., Client 1 was in the bathroom seated on the toilet when she was again observed opening the door and exposing herself and was redirected by staff. At 8:25 A.M., during observation of breakfast, Client 1 insisted that she had to use the bathroom even though she had used it several times prior to the start of the meal. When she was redirected by the Director of Residential Services, Client 1 pulled her pants down in front of the other clients and staff. She was redirected to her room. Shortly after, Client 1 calmed down and joined the others for breakfast. The Director of Residential Services stated that Client 1's behavior was fairly new. Client 1 was observed repeating the above behaviors numerous times during the course of the survey, between 12/06/04 and 12/08/04. Client 1 <<,s medical record was reviewed on 12/08/04. There was no documentation in the medical record or the program books on 12/06/04, 12/07/04 or 12/08/04, regarding staffs observations and interventions of the clients ID PREFIX TAG W254 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Staff Error Staff failed to follow established procedures on documenting new behaviors. Staff have been retrained 1 to use observation sheets to document any new behavic QMRP responsible for monitoring. <X5) COMPLETION DATE /15/05 rs. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 11 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/20O FORM APPROVE! OMB NO. 0938-059' STATEMENT OF'DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE W254 W262 Continued From page 11 bathroom door opening behaviors and/or removing her underwear in front of staff and peers. Client 1's medical record was jointly reviewed with the Qualified Mental Retardation Professional (QMRP) 2 on 12/8/04 at 12:30 P.M. She stated that staff had informed her of the new behavior a couple months prior, however, the staff had not consistently documented the number of occurrences so that a plan could be developed to address the target behaviors. She acknowledged that there was no documentation on the behavior observation sheets or data collection sheets related to the new behavior. 483.440(f)(3)(i) PROGRAM MONITORING & CHANGE The committee should review, approve, and monitor individual programs designed to manage inappropriate behavior and other programs that, in the opinion of the committee, involve risks to client protection and rights. This STANDARD is not met as evidenced by: Based on interview and record review, the Human Rights Committee failed to review the use of a door alarm, for 1 of 3 sampled clients (3). The findings include: Client 3 was observed on 12/06/04, between 4:05 P.M. and 8:00 P.M. He was nonverbal and communicated through signs and gestures. He ambulated independently. He was independent with most of his activities of daily living such as eating, dressing, and personal hygiene. A door W254 W262 See response for W128.1/15/05 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 12 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROV1DER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 awlNG 12/09/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE ,. ne>-r*,Jn,,w 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W262 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 12 chime was observed secured to the outside of his bedroom door. A key hung from a chain and was also secured to the outside of the bedroom door. On 12/08/04 at 7:35 A.M., the door alarm sounded as Client 3 exited his bedroom door. Direct Care Staff (DCS) 4 turned off the alarm. Direct Care Staff (DCS) 1 was interviewed on 12/08/04, at 3:30 P.M. She stated she worked the previous evening with a DCS that was unfamiliar with the house routine. She stated he must have set the alarm when he prepared the client for bed. She stated the alarm was not supposed to be set at night. \ Client 3</,s medical record was reviewed on 12/08/04. Client 3 was admitted to the facility on 5/03/85 with a diagnosis of profound mental retardation according to the face sheet. The behavior plan, dated 8/13/04, indicated the clients target behaviors were identified as, ^Wandering to seek items to tear: This includes leaving the group in a building, wandering outside a building, or leaving the group in a public area. 6 The behavior plan interventions did not include the use of the bedroom door alarm. In addition, the medical record did not contain a written consent for the use of the door alarm. The Human Rights Committee meeting minutes were reviewed on 12/08/04. The previous 12 months of meeting minutes were reviewed. There was no documentation to indicate the committee reviewed the use of the alarm on Client 3£s bedroom door. Qualified Mental Retardation Professional (QMRP) 2 was interviewed on 12/08/04 at 3:30 ID PREFIX TAG W262 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 13 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/20O FORMAPPROVEC OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (XS) COMPLETION DATE W262 W263 Continued From page 13 P.M. She stated the use of the door alarm was discontinued more than one-year prior and the door alarm was, ^Not supposed to be on.,*, She stated she had not reviewed the use of the alarm with the Human Rights Committee. 483.440(f)(3)(ii) PROGRAM MONITORING & CHANGE The committee should insure that these programs are conducted only with the written informed consent of the client, parents (if the client is a minor) or legal guardian. This STANDARD is not met as evidenced by: Based on interview and record review, the facility failed to obtain informed consent for the use of a door alarm, for 1 of 3 sampled clients (3). The findings include: Client 3 was observed on 12/06/04, between 4:05 P.M. and 8:00 P.M. He was nonverbal and communicated through signs and gestures. He ambulated independently. He was independent with most of his activities of daily living such as eating, dressing, and personal hygiene. A door chime was observed secured to the outside of his bedroom door. A key hung from a chain and was also secured to the outside of the bedroom door. On 12/08/04 at 7:35 A.MM the door alarm sounded as Client 3 exited his bedroom door. Direct Care Staff (DCS) 4 turned off the alarm. Direct Care Staff (DCS) 1 was interviewed on 12/08/04 at 3:30 P.M. She stated she worked the previous evening with a DCS that was unfamiliar W262 W263 See response to W125.1/15/05 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 14 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-Q3Q1 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W263 W315 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION IDENTIFICATION NUMBER:A. BUILDING 05G952 awlNG STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 14 with the house routine. She stated he must have set the alarm when he prepared the client for bed. She stated the alarm was not supposed to be set at night. Client 3£s medical record was reviewed on 12/08/04. Client 3 was admitted to the facility on 5/03/85 with a diagnosis of profound mental retardation according to the face sheet. The behavior plan, dated 8/13/04, indicated the clients target behaviors were identified as, i Wandering to seek items to tear: This includes leaving the group in a building, wandering outside a building, or leaving the group in a public area.i The behavior plan interventions did not include the use of the bedroom door alarm. In addition, the medical record did not contain a written consent for the use of the door alarm. Qualified Mental Retardation Professional (QMRP) 2 was interviewed on 12/08/04 at 3:30 P.M. She stated the use of the door alarm was discontinued more than one-year prior and the door alarm was, i,Not suppose to be on.,;. She stated she did not obtain an informed consent from the client or the responsible party for the use of the bedroom door alarm. 483.450(e)(4)(i) DRUG USAGE Drugs used for control of inappropriate behavior must be monitored closely for desired responses and adverse consequences by facility staff. This STANDARD is not met as evidenced by: Based on interview and record review, ID PREFIX TAG W263 W315 (X3) DATE SURVEY COMPLETED 12/09/2004 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) - (X5) COMPLETION DATE FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 15 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/20(M FORM APPROVED OMB NO. 0938-03-91 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 aWING 12/09/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE . T. 11^lt«_ 6433 FLAMENCO STREETLA COSTA HOUSEnwuoc CARLSBAD, CA 92008 (X4) ID PREFIX TAG W315 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 1 5 medications that were used to control inappropriate behavior were not closely monitored for desired responses and adverse consequences, for 3 of 3 sampled clients (1,2, 3). The findings include: 1 . Client 1 was admitted to the facility on 1 1/02/87, with diagnoses that included severe mental retardation, per the face sheet. Per the Physician's Orders dated 11/10/04, the client received Trazodone 100 milligrams (mg.) every night for sleep. Client 1 's record was jointly reviewed with QMRP 2 on 12/08/04 at 12:30 P.M. Per the Psychiatric Review, dated 11/10/04, the client was assessed as sleeping better, however the client required PRN (as needed) medications twice during the month. The plan was to continue the Trazodone, although the administration time was changed from 8:00 P.M. to 9:30 P.M. The psychiatrist recommendations and interventions included, ^Monitor symptoms and side effects, continue medication, and behavioral interventions. ^ Even though staff monitored other nighttime behavior, there was no evidence located in the medical record that the clients sleep patterns were routinely monitored to determine the efficacy of the prescribed medication or any adverse consequences of the medication. 2. Client 3 was admitted to the facility on 8/16/85 with diagnoses that included profound mental retardation per the face sheet. Per the Physician's Orders dated 9/21/04, the client received Remeron 15 mg. at night for depression. Client 3's record was jointly reviewed with QMRP 2 on 12/8/04 at 12:15 P.M. While staff monitored ID PREFIX TAG W315 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 1 . A chart will be develoj to indicate if client slept or not or needed PRN. This information will be relayed to the psychiatrist monthly. See attachments #8, 9. RN/QMRP responsible for monitoring. (X5) COMPLETION DATE 715/05>ed FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 16 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-03Q1 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W315 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWING 12/09/2004 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 16 other behaviors, there was no documentation located in the medical record that defined the client's symptoms of depression. QMRP 2 was not able to specify how the depression was manifested so that staff were aware of what behavior to monitor. 3a. Client 2 was observed on 12/06/04, between 4:05 P.M. and 8:00 P.M. and on 12/07/04 between 6:15 A.M. and 9:20 A.M. He communicated through signs, gestures, and use of a picture book. He focused on a single topic and repeated the topic of interest to each staff member several times until he was redirected. He ambulated independently. He was independent with most of his activities of daily living such as eating, dressing, and personal hygiene. Client 2,;,s medical record was reviewed on 12/08/04. Client 2 was admitted to the facility on 9/07/82, with diagnoses that included moderate mental retardation and congenital encephalopathy (dysfunction of the brain), according to the face sheet. Review of the attending physician^s orders, dated 11/20/02, indicated the client was prescribed Risperdal (an antipsychotic medication) 2 milligrams (mg) daily at 8:00 P.M. for psychotic behavior. There was no documentation in the medical record to describe the signs and symptoms of the clients psychotic behaviors. According to the psychiatric review, dated 1 1/10/04, the clients target symptoms were physical aggression, agitation, irritability, tantrums, and anxiety. There was no mention of psychotic behaviors, however the psychiatrists plan included, <|,Cont (continue) Risperdal.i, The ID PREFIX TAG W315 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 2. The psychiatrist monit behaviors from information gathered from documentatio and incident reports. Eaa chart has a sheet of side effects for staff to refer to. The RN writes monthly notes indicating side effects and^nElftent reports. The staff comple a form and brings to meeting where side effects are discussed with behavio team. \O id I/] I V P (l(>dj* ^ihll^)<SAJ / (j( H{/M l(JLxl#tM2v^ F Xx_ /f. /pf ^Jh^yfjnj (X5) COMPLETION DATE /15/05>rs i i :es ral FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 17 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2CKM FORM APPROVED OMB NO. 0938-0331 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W315 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 B'WING 12/09/2004 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 17 psychiatrist recommendations and interventions included, ^Monitor symptoms and side effects, continue medication, and behavioral interventions. £ There was no documentation to indicate the clients psychotic behavior was routinely monitored to determine efficacy of the prescribed medication. There was also no behavioral plan to address the clients psychosis. The Qualified Mental Retardation Professional (QMRP) was interviewed on 12/08/04, at 1 1 :20 AM. She acknowledged the facility did not identify and monitor the clients target signs and symptoms of psychosis for which the client was prescribed medication. 3b. According to the physician^s orders, dated 12/14/01, Client 2 was prescribed Benadryl 50 mg at 8:00 P.M. for sleep. According to the psychiatric review, dated 11/10/04, the clients target symptoms were physical aggression, agitation, irritability,tantrums, and anxiety. Insomnia was not identified as a target symptom despite the fact that the client was prescribed medications for sleep. The psychiatrist recommendations and interventions included, ^Monitor symptoms and side effects, continue medication, and behavioral interventions. £ There was no documentation in the medical record to indicate the clients sleep patterns were routinely monitored to determine efficacy of the prescribed medication. The Qualified Mental Retardation Professional (QMRP) 2 was interviewed on 12/08/04 at 11:20 A.M. She stated the client had a history of ID PREFIX TAG W315 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 3b. A monthly sleep calendar will be kept on this individual. RN/QMRP responsible for monitoring. (X5) COMPLETION DATE 1/15/05 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 18 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W315 W324 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 aWING 12/0 9/2004 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 18 sleeping only three to five hours per night for several years. She acknowledged the facility did not monitor the clients sleep patterns to determine if the client still required the medication for sleep. 483.460(a)(3)(ii) PHYSICIAN SERVICES The facility must provide or obtain annual physical examinations of each client that at a minimum includes immunizations, using as a guide the recommendations of the Public Health Service Advisory Committee on Immunization Practices or of the Committee on the Control of Infectious Diseases of the American Academy of Pediatrics. This STANDARD is not met as evidenced by: Based on interview and record review, the facility failed to maintain current immunizations, for 3 of 3 sampled clients (1, 2, 3). The findings include: 1. Client 1£S medical record was reviewed on 12/08/04. She was admitted to the facility on 1 1/02/87 with a diagnosis of severe mental retardation according to the face sheet. According to the immunization records, there was no documentation to indicate the client received Hepatitis A and Hepatitis B vaccinations or laboratory screenings to determine immunity. According to the health care plan, the client was to receive, ^Annual PE (physical examination) including evaluation of hearing, routine immunization, Hep (hepatitis) t,&l and TB skin testing or chest x-rays as appropriate, UA, blood tests as appropriate, Hep i&i vaccine as ID PREFIX TAG W315 W324 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Hep B titers/injections are given upon initial admission to facility. Hep titen has not been established and will be done in 2005. HepB immunit is to be lifelong so no further test will be performed if client has immunity. No regs on HepA vaccine. RN -re»c;pnn<=;ib1 P> for monitor! <X5) COMPLETION DATE 1/25/05 B Y ng. FORMCMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 19 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/200 FORM APPROVE! OMB NO. 0938-039' STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 05G952 (X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING (X3) DATE SURVEY COMPLETED 12/09/2004 NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) ID PREFIX TAG PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) <X5) COMPLETION DATE W324 Continued From page 19 necessary, i The licensed nurse was interviewed via telephone on 12/08/04 at 12:40 P.M. She stated that the clients vaccinations were reviewed upon admission to the facility. Vaccinations were given during the admission process. She stated that she did not routinely assess the clients to assure that their vaccinations were up to date. She stated the facility did not routinely collect hepatitis tilers to determine the clients' Hepatitis immunity status. 2. Client 2<>,s medical record was reviewed on 12/08/04. He was admitted to the facility on 9/07/82, with diagnoses that included moderate mental retardation and congenital encephalopathy (dysfunction of the brain) according to the face sheet. According to the immunization record, the client last received Hepatitis A and Hepatitis B laboratory screening tests on 12/23/83. There was no documentation to indicate the client received the Hepatitis A and Hepatitis B vaccinations or additional laboratory screening tests to assure the client was immune to hepatitis. There was also no documentation to indicate the client received measles, mumps, and rubella (MMR) vaccinations. According to the health care plan, revised on 10/26/04, the client was to receive, ^Annual PE (physical examination) including evaluation of hearing, routine immunization, Hep (hepatitis) iPi, and TB skin testing or chest x-rays as appropriate, UA, blood tests as appropriate, Hep vaccine as necessary.,*. W324 2. See response to #1./25/05 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 20 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W324 (X1) PROV1DER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION IDENTIFICATION NUMBER:A. BUILDING 05G952 aWING- STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 20 The licensed nurse was interviewed via telephone on 12/08/04 at 12:40 P.M. She stated that the clients vaccinations were reviewed upon admission to the facility. Vaccinations were given during the admission process. She stated that she did not routinely assess the clients to assure that their vaccinations were up to date. She stated the facility did not routinely collect hepatitis titers to determine immunity status. 3. Client S^s medical record was reviewed on 12/08/04. Client 3 was admitted to the facility on 5/03/85 with a diagnosis of profound mental retardation according to the face sheet. According to the immunization record, the client last received Hepatitis A and Hepatitis B laboratory screening tests on 5/10/85. There was no documentation to indicate the client received the Hepatitis A and Hepatitis B vaccinations or additional laboratory screening tests to assure the client was immune to hepatitis. There was also no documentation to indicate the client received a smallpox vaccination. According to the health care plan, revised on 10/26/04, the client was to receive, ^Annual PE (physical examination) including evaluation of hearing, routine immunization, Hep (hepatitis) i,Bd, and TB skin testing or chest x-rays as appropriate, UA, blood tests as appropriate, Hep i&i vaccine as necessary. £ The licensed nurse was interviewed via telephone on 12/08/04 at 12:40 P.M. She stated that the clients vaccinations were reviewed upon admission to the facility. Vaccinations were given during the admission process. She stated that she did not routinely assess the clients to assure ID PREFIX TAG W324 (X3) DATE SURVEY COMPLETED 12/09/2004 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 3. See response to #2 (X5) COMPLETION DATE FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 21 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/200* FORMAPPROVEC OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA BUILDING 05G952 BWING 12/0J/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W324 W325 SUMMARY STATEMENT OF DEFICIENCIES . (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 21 that their vaccinations were up to date. She stated the facility did not routinely collect hepatitis liters annually to determine the clients' immunity to hepatitis. 483.460(a)(3)(iii) PHYSICIAN SERVICES The facility must provide or obtain annual physical examinations of each client that at a minimum includes routine screening laboratory examinations as determined necessary by the physician. This STANDARD is not met as evidenced by: Based on interview and record review, the facility failed to obtain annual routine lab work, for 1 of 3 sampled clients (1); and, failed to obtain a yearly electrocardiogram (EKG), for 1 of 3 sampled clients (3). The findings include: 1. Client 1 was admitted to the facility on 1 1/02/87 with diagnoses that included severe mental retardation per the face sheet. Client 1's record was reviewed on 12/8/04 at 12:30 P.M. Per physician^s orders, dated 8/20/97; the physician ordered a urinalysis (UA) to be obtained annually. There were no urinalysis results found in the record and no documentation that indicated the test was completed. The licensed nurse (LN) was interviewed via telephone on 12/8/04 at 12:40 P.M. She stated that the client was taken to the clinic to have blood work collected in September 2004. The urinalysis was not completed because the client was uncooperative. The LN said that she had ID PREFIX TAG W324 W325 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) RN Error EKG's were done on client but unable to get results from hospital due to HIPPA Will present form to hospi allowing TERI, Inc. author ization to hospital records to get reports and establii with administration at hos] protocol in getting report: RN responsible. (X5) COMPLETION DATE /5/05 :al - > ;h )ital 5 » FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 22 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWING 12/09/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE ~«,., ,.^.,<,^ 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W325 W326 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 22 planned to take the client back to the clinic for another attempt, but forgot to take the client back. 2. Client 3 was admitted to the facility on 5/03/85, with diagnoses that included profound mental retardation, per the face sheet. Client 3's record was reviewed on 12/08/04 at 12:15 P.M. Per the physician^s orders, dated 6/22/01; the physician ordered that an annual EKG be obtained. The order was repeated on 10/08/03, 'Yearly EKG due to psychotropic drugs." The most recent EKG found in the record was dated 1 1/12/03. There was no indication that an EKG was conducted in November 2004, as ordered by the physician. The LN was interviewed on 12/08/04 at 12:40 P.M. via telephone. She stated that she was not aware that the EKG had yet to be completed. 483.460(a)(3)(iii) PHYSICIAN SERVICES The facility must provide or obtain annual physical examinations of each client that at a minimum includes special studies when needed. This STANDARD is not met as evidenced by: Based on interview and record review the facility failed to repeat lab work as ordered by the physician when the results were reported as abnormal, for 1 of 3 sampled clients (1). The findings include: Client 1 was admitted to the facility on 1 1/2/87, ID PREFIX TAG W325 W326 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 2. See response to #1 1 RN Error Lab work should be complet< in a timely manner from on date. The RN's will revie monthly each other's requests to ensure compliance. RN responsible/QMRP to mon (XS) COMPLETION DATE /15/05 /15/05 3d 3er v itor FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 23 of 26 t, *- DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-03*91 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W326 W368 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 B'WING 12/09/2004 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 23 with diagnoses that included severe mental retardation per the face sheet. Client 1's record was reviewed on 12/08/04. The client had routine lab work collected on 9/17/04. The TSH (thyroid test) was 9.497, which was elevated (normal 0.3-5.0). The physician ordered a repeat of the lab tests to be collected in one month. There was no indication that the tests were repeated as ordered. The licensed nurse was interviewed via telephone on 12/08/04 at 12:40 P.M. She stated that she was unaware that the lab tests had yet to be completed. 483.460(k)(1) DRUG ADMINISTRATION The system for drug administration must assure that all drugs are administered in compliance with the physician's orders. This STANDARD is not met as evidenced by: Based on observation, interview, and record review, the facility failed to ensure that medications were administered in compliance with the physician's orders, for 1 client added to the sample (6). The findings include: Client 6 was admitted to the facility on 8/24/83, with diagnoses that included Down^s syndrome and profound mental retardation, according to the face sheet. During the medication pass on 12/07/04 at 7:20 A.M., Direct Care Staff (DCS) 1 was observed to administer eye drops and oral Augmentin to ID PREFIX TAG W326 W368 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Staff Error The DCS failed to make a copy of order before giving to pharmacy. RN will remind DCS to get a copy and retrieve copy froi pharmacy. (see attachment RN responsible for monitor: (X5) COMPLETION DATE n #4). ing. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 24 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG W368 W390 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 B'WING 12/09/2004 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 24 Client 6. When the administered medications were reconciled the following day at 9:30 A.M., there was no written physician^s order located in the medical record for the use of the eye drops or the oral antibiotic. The licensed nurse was interviewed on 12/08/04 at 12:40 via telephone. She stated that she knew the original order existed because it was needed to obtain the prescription from the pharmacist; however, she was unable to provide a copy of the order. 483.460(m)(2)(i) DRUG LABELING The facility must remove from use outdated drugs. This STANDARD is not met as evidenced by: Based on observation and interview the facility failed to ensure that outdated medications were removed from the medication area. The findings include: 1. On 12/06/04 at 3:50 P.M., during inspection of the drug storage area, 7 packets Alka-Seltzer had an expiration date of January 2003. 2. An opened tube of triple antibiotic ointment had an expiration date of July 2002. Direct Care Staff (DCS) 1 was interviewed at that time and she acknowledged the medications were expired. ID PREFIX TAG W368 W390 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) 1 .42. Staff Errori Expired med's are to be placed in a discard box and removed by nurse at monthly pharmacy review RN and pharmacist will do a better job at pharmacy review. (X5) COMPLETION DATE 12/11/0 • FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 25 of 26 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/21/2004 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA BUILDING 05G952 BWING 12/09/2004 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W391 W391 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 25 483.460(m)(2)(ii) DRUG LABELING The facility must remove from use drug containers with worn, illegible, or missing labels. This STANDARD is not met as evidenced by: Based on observation and interview, the facility failed to ensure that all medications were stored and labeled correctly. The findings include: During inspection of the drug storage area on 12/06/04 at 3:50 P.M., a plastic bag containing four white tablets was labeled, "Ibuprofen 200 mg." There was no expiration date documented on the plastic bag. Direct Care Staff (DCS) 1 was interviewed at that time and she stated that the medication was for the staff when someone had a headache. DCS 1 acknowledged that the medication was incorrectly stored and not labeled properly. ID PREFIX TAG W391 W391 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Staff Error The medication was DCS medication and has been removed from the facility. The DCS have been instruct< not to leave their medication in our medicine cabinet, to keep any personal med's out of the medication cabinet. RN responsible for monitor: (X5) COMPLETION DATE /11/05 id .ng. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: NZHN11 Facility ID: CA090000123 If continuation sheet Page 26 of 26 ^DEPARTMENT OF HEALTH AND HUMAN SERVICES \ENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 12/20/2005 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG WOOD W120 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: ^ BUILDING COMPLETED nc^nci ..<Kt& B. WINGUOuaO^j tj^ ri^J 12/013/2005 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) INITIAL COMMENTS The following reflects the findings of the Department of Health Services during a FUNDAMENTAL survey visit. Representing the Department of Health Anna Soliven, HFEN. Services: The facility census at the time of the survey was 6 clients. The sample size was 3 clients. 483.410(d)(3) SERVICES PROVIDED WITH OUTSIDE SOURCES The facility must assure that outside services meet the needs of each client. This Standard is not met as evidenced by: Based on observation, interview, and record review, the facility failed to ensure that the 1 of 3 sampled clients (2), was monitored for seizures at his day program. Findings: An observation of Client 2 was conducted at his day program on 12/07/05 at 9:25 A.M. Client 2 sat in a chair at a table, working on his grooming exercises with the staff. He brushed his hair after a verbal prompt by the staff. An interview was conducted with the staff on 12/07/05 at 9:45 A.M. She stated that Client 2 did not have a seizure disorder and that he was not monitored for any seizures. A review of Client 2 s medical record was conducted on 12/08/05. The client was on ID PREFIX TAG WOOD W 120 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Day Program Supervisor has revised client information sheet to include this information and trained the client's day program staff. The information was contained in the medical summary. QMRP is responsible for ensuring that the day program staff are knowledgeable about client medical conditions. (X5) COMPLETION DATE <*-„-« LABORATO VIDER/SUPPLIER REPRESENTATIVE'S SIG TITLE (X6)DATE Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution/may be excused from correcting providing it is daerrmried that other safeguards provide sufficient protection to the patients. (See instructions.) Except forWrsing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. FORM CMS-2567(02-99) Previous Versions Obsolete PIIK11 If continuation sheet Page 1 of 6 DEPARTMENT OF HEALTH CENTERS FOR MEDICARE STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4)ID PREFIX TAG W120 W124 Printed: 12/20/2005 AND HUMAN SERVICES FORM APPROVED & MEDICAID SERVICES OMB NO. 0938-03ifir i (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY i IDENTIFICATION NUMBER: A BU|LD|NG COMPLETED 05G952 B. WING 12/013/2005 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 1 Phenobarbital medication for seizures and he had a health care plan in place for the seizure disorder. The Director of Residential Services acknowledged during an interview on 12/08/05 at 12:50 P.M., that the day program staff should have been aware that Client 2 needed to be monitored for any seizure activity. 483.420(a)(2) PROTECTION OF CLIENTS RIGHT*?r\i vji i i o The facility must ensure the rights of all clients. Therefore the facility must inform each client, parent (if the client is a minor), or legal guardian, of the client's medical condition, developmental and behavioral status, attendant risks of treatment, and of the right to refuse treatment. This Standard is not met as evidenced by: Based on interview and record review, the facility failed to obtain an informed consent for the use of a hypnotic medication, for 1 of 3 sampled clients (4); and the facility failed to obtain recent consents for medical treatment, the use of psychotropic medications, the release of information, use of the pool, the use of alarms, and the locking of knives and cleaning supplies in the house, for 1 of 3 sampled clients (Client 2). Findings: 1 . A review of Client 4's medical record was conducted on 12/08/05. Client 4 was admitted to the facility on 1 1/02/87, with the diagnosis of severe mental retardation, per the client identification and emergency information sheet. ID PREFIX TAG W120 W124 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Consents have been sent to client 2 ' s family again with a phone call. This individual's family is slow to respond to request and has limited involvemen with the client. The use of psychotropic medications; use of house alarms and the locking of cleaning supplies and locking knives are all reviewed quarterly at the Human Rights meeting. QMRP is responsible for contacting family members and attempting to obtain signed consents. (X5) COMPLETION PIATCUM I c 1-8-06 > FORM CMS-2567(02-99) Previous Versions Obsolete PIIK11 If continuation sheet Page 2 of 6 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 12/20/2005 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BU|LDING COMPLETED 05G952 BWING 12/0!3/2005 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID\rrrj iv PREFIX TAG W124 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 2 According to the June 2005 summary nursing notes, Client 4's nighttime behaviors and insomnia had increased. On 06/22/05, the physician ordered Ambien 10 milligrams (hypnotic medication) 1 tablet by mouth as needed at bedtime for sleep, and to give before 11 P.M. Client 4 had received a total of 4 doses of Ambien and the medication was discontinued on 07/13/05. Further review of the medical record revealed that consent for the use of the Ambien had not been obtained. The Director of Residential Services acknowledged during an interview on 12/08/05 at 12:50 P.M., that an informed consent for the use of Ambien should have been obtained from the client's responsible party prior to its use. 2. A review of Client 2's medical record was conducted on 12/08/05. Client 2 was admitted to the facility on 05/03/85, with the diagnosis of profound mental retardation associated, per the client identification and emergency information sheet. Review of the medical record revealed that the most recent consent forms for medical treatment, the use of psychotropic medications, the release of information, the pool, the alarm, and the locking of knives and cleaning supplies in the house had not been signed. Copies of the consents had been sent to a family member on 07/13/05 to be signed. No further follow up had been attempted to get the consents signed. The Director of Residential Services acknowledged during an interview on 12/08/05 at 12:50 P.M. that the informed consent forms should have been signed by an involved family ID PREFIX TAG W124 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE FORM CMS-2567(02-99) Previous Versions Obsolete PIIK11 If continuation sheet Page 3 of 6 Printed: 12/20/2005 DEPARTMENT OF HEALTH AND HUMAN SERVICES FORM APPROVED CENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 0938-03*1 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BU|LD|NG COMPLETED 05G952 awlNG 12/013/2005 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID\»"/ ltrf PREFIX TAG W124 W325 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 3 member and/or other attempts made to have them signed. 482.460(a)(3)(iii) PHYSICIAN SERVICES The facility must provide or obtain annual physical examinations of each client that at a minimum includes routine screening laboratory examinations as determined necessary by the physician. This Standard is not met as evidenced by: Based on interview and record review, the facility failed to provide an electrocardiogram as ordered by the physician, for 1 of 3 sampled clients (2). Findings: A review of Client 2's medical record was conducted on 12/08/05. Client 2 was admitted to the facility on 05/03/85, with the diagnosis of profound mental retardation, per the client identification and emergency information. Review of the medical record revealed that the physician on 06/22/01 , ordered an EKG (electrocardiogram) to be checked annually. EKGs, however, for 2004 and 2005 could not be found in the record. An interview was conducted with the Director of Residential Services on 12/08/05 at 12:50 P.M. She agreed that the EKG should have been obtained annually as ordered by the physician. ID PREFIX TAG W124 W325 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) EKG was done on 12-16-05. RN responsible for ensurin that labs ordered by a physician are completed in a timely manner and documented in the client record. (X5) COMPLETION DATE 1-8-05 g FORM CMS-2567(02-99) Previous Versions Obsolete PIIK11 If continuation sheet Page 4 of 6 .DEPARTMENT OF HEALTH AND HUMAN SERVICES SENTERS FOR MEDICARE & MEDICAID SERVICES Printed: 12/20/2005 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BU|LD|NG COMPLETED 05G952 BWING 12/013/2005 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG W390 W390 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 4 483.460(rn)(2)(i) DRUG LABELING The facility must remove from use outdated drugs. This Standard is not met as evidenced by: Based on observation and interview, the facility failed to ensure that expired medications and biologicals were not stored in the current drug supply. Findings: The medication area inspection and audit was conducted on 12/07/05 at 8:40 A.M. The following items were found to be outdated: 1. Two 1-fluid ounce of sterile eye wash bottles had the expiration dates of February 2003 and February 2004. 2. A bottle of pseudoephedrine 60 milligrams that contained 13 tablets, had the expiration date August 2005. 3. A bottle of Nasonex nasal spray had the expiration date of October 2005. 4. An opened box of Claritin 10 milligrams that contained 7 tablets, had the expiration date of June 2005. 5. Two 1 ounce triple antibiotic ointment tubes had the expiration date of October 2005. 6. A tube of Tinactin cream that was 3/4 full had the expiration date of November 2005. 7. A 0.25 ounce of Aquaphor ointment tube had the expiration date of May 1 998. ID PREFIX TAG W390 W390 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) The facility RN has removed the expired medications and biological The RN is responsible for ensuring that outdated drugs are removed from the current drug supply. (X5) COMPLETION DATE 2-12^-05 s. FORM CMS-2567(02-99) Previous Versions Obsolete PIIK11 If continuation sheet Page 5 of 6 Printed: 12/20/2*005 DEPARTMENT OF HEALTH AND HUMAN SERVICES FORM APPROVED CENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 0938-OM1<•' f i STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY < AND PLAN OF CORRECTION IDENTIFICATION NUMBER: A BUILDING COMPLETED 05G952 BWING-12/013/2005 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4)ID PREFIX TAG W390 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 5 The QMRP (qualified mental retardation professional) verified the expired dates during a joint review of the medications on 12/07/05 at 8:50 A.M. ID PREFIX TAG W390 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION FORM CMS-2567(02-99) Previous Versions Obsolete PIIK11 If continuation sheet Page 6 of 6 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 01/26/2007 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION * NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG WOOD W124 (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 aWING 01/1 9/2007 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA- 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) INITIAL COMMENTS The following reflects the findings of the Department of Health Services during a FUNDAMENTAL survey. Representing the Department: Aty Knooren, HFEN. The census at the time of the survey was 6 clients. The sample size was 3 clients. 483.420(a)(2) PROTECTION OF CLIENTS RIGHTS The facility must ensure the rights of all clients. Therefore the facility must inform each client, parent (if the client is a minor), or legal guardian, of the client's medical condition, developmental and behavioral status, attendant risks of treatment, and of the right to refuse treatment. This STANDARD is not met as evidenced by: Based on interview and record review the facility failed to obtain informed consents for the use of psychotropic medications for 2 of 3 sampled clients (1, 3). Findings: 1 . According to the client's face sheet, Client 1 was admitted to the facility on 11/2/87 with diagnoses that included severe mental retardation.* Record review on 1/18/07 indicated that according to the physician order form dated 11/06, Client 1 had an order for Seroquel 100 mg, 2 tablets (200mg) every night for manic behavior. ID PREFIX TAG WOOO W124 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) Consents have been resent to family members and QMRP will follow up with phone call if necessary. QMRP responsible for ensuring consents are signed in a timely manner . <X5) COMPLETION DATE 2/19/07 UBORATOR&IRECTOR'StiR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused/rdm correcting providing it is deterrrfinea that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, theumdings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: 276O11 Facility ID: CA090000123 If continuation sheet Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 01/26/2007 FORM APPROVED OMB NO. 093&-QJ391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED . 'A. BUILDING 05G952 BWING 01/19/2007 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE ~~,.. ,.~.,~r. 6433 FLAMENCO STREETLA COSTA HOUSE CARLSBAD , CA 92008 (X4) ID PREFIX TAG W124 W261 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 1 There was also a second order for Seroquel 50 mg 1 tablet as needed, at night if not asleep by 1 1 :00 P.M. The consent for Seroquel was dated 8/5/05. The "consent for use of psychotropic medications" forms dated 10/10/06 indicated that the consents were valid for a period of one year. The Qualified Mental Retardation Professional (QMRP) was interviewed on 1/18/07 at 3:00 P.M. She acknowledged that the consent was not signed on an annual basis. 2. According to the client's face sheet, Client 3 was admitted to the facility on 9/1/82 with diagnoses that included severe mental retardation. Record review on 1/18/07 indicated that according to the physician order form dated 11/06, Client 3 had an order for perphenazine (Trilafon) 4 mg every morning and perphenazine (Trilafon) 8 mg every evening for psychosis. The "consent for use of psychotropic medications" form dated 7/21/05 indicated that the consent was valid for a period of one year. The Qualified Mental Retardation Professional (QMRP) was interviewed on 1/18/07 at 3:00 P.M. She acknowledged that the consent was not signed on an annual basis. 483.440(f)(3) PROGRAM MONITORING & CHANGE The facility must designate and use a specially constituted committee or committees consisting of members of facility staff, parents, legal guardians, clients (as appropriate), qualified persons who have either experience or training in contemporary practices to change inappropriate ID PREFIX TAG W 124 \ . W261 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) A community representative has been identified for the HR Committee. Director of Adult Services responsible for compliance (X5) COMPLETION DATE 2/19/0/ FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: 276O11 Facility ID: CA090000123 If continuation sheet Page 2 of 3 qEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 01/26/2007 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES <xi) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3> DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWING 01/19/2007 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE . . ««.,-r. u^.-or- 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W124 W261 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 1 There was also a second order for Seroquel 50 mg 1 tablet as needed, at night if not asleep by 1 1 :00 P.M. The consent for Seroquel was dated 8/5/05. The "consent for use of psychotropic medications" forms dated 10/10/06 indicated that the consents were valid for a period of one year. The Qualified Mental Retardation Professional (QMRP) was interviewed on 1/18/07 at 3:00 P.M. She acknowledged that the consent was not signed on an annual basis. 2. According to the client's face sheet, Client 3 was admitted to the facility on 9/1/82 with diagnoses that included severe mental retardation. Record review on 1/18/07 indicated that according to the physician order form dated 1 1/06, Client 3 had an order for perphenazine (Trilafon) 4 mg every morning and perphenazine (Trilafon) 8 mg every evening for psychosis. The "consent for use of psychotropic medications" form dated 7/21/05 indicated that the consent was valid for a period of one year. The Qualified Mental Retardation Professional (QMRP) was interviewed on 1/18/07 at 3:00 P.M. She acknowledged that the consent was not signed on an annual basis. 483.440(f)(3) PROGRAM MONITORING & CHANGE The facility must designate and use a specially constituted committee or committees consisting of members of facility staff, parents, legal guardians, clients (as appropriate), qualified persons who have either experience or training in contemporary practices to change inappropriate ID PREFIX TAG . W124 \ W261 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X5) COMPLETION DATE FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: 276011 Facility ID: CA090000123 If continuation sheet Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/11/2008 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION NAME OF PROVIDER OR SUPPLIER LA COSTA HOUSE (X4) ID PREFIX TAG WOOD W130 ^ (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWlNG 12/0 5/2008 STREET ADDRESS, CITY, STATE, ZIP CODE 6433 FLAMENCO STREET CARLSBAD, CA 92008 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) INITIAL COMMENTS The following reflects the findings of the California Department of Public Health during a FUNDAMENTAL survey. Representing the Department: Aty Knooren, HFEN. The census during the survey was 6 clients. The survey sample was 3 clients. 483.420(a)(7) PROTECTION OF CLIENTS RIGHTS The facility must ensure the rights of all clients. Therefore, the facility must ensure privacy during treatment and care of personal needs. This STANDARD is not met as evidenced by: Based on observation, interview and record review, the facility failed to ensure the privacy of 1 sampled client (1) while she used the bathroom. Findings: According to the client's face sheet, Client 1 was admitted to the facil ty on 1 1/2/87, with diagnoses that included severe mental retardation. Client 1 was observed in her home on 12/2/08, when she arrived home from her day program at 4:00 P.M. Client 1 used the hallway bathroom, (visible from the dining area) independently, while leaving the bathroom door open. She was observed again using the bathroom before dinner at 5:30 P.M. and she left the door open again. The direct care staff (DCS) did not prompt the client to close the door in a timely manner. The Qualified Mental Retardation Professional ^^^^^^SJJ^^^^^ ID PREFIX TAG WOOD W130 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) The facility shall ensure the rights of all clients including ensuring privacy during treatment and care of personal needs. The staff has been trained on the need to ensure the privacy of all residents in a timely manner by the QMRP. The QMRP and Director of Residential Services shall monitor by direct observation to ensure that this regulation continues to be met. (X5) COMPLETION DATE 12/05/08 ATUR&O \ ( — vO/1 TITtE r\ i (X6) DATEu tl\£\\&VWjbo l^-i^.-c^ \ny deficiency statement ending with an asterisk (*fdenotes a deficiency which the institution may be excused from correcting providing it is determined that Dther safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 jays following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued Drogram participation. =ORM CMS-2567(02-99) Previous Versions Obsolete Event ID: DU2G11 Facility ID: CA090000123 If rnntinnatirtn cheat Pano 1 nf 1 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/11/200& FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 B'WlNG 12/05/2008 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA COSTA HOUSE 6433 FLAMENCO STREET CARLSBAD, CA 92008 (X4) ID PREFIX TAG W130 W322 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 1 (QMRP) was interviewed after the observations. She stated that this was an isolated incident and acknowledged that the DCS should have ensured the client's privacy in a more timely manner. 483.460(a)(3) PHYSICIAN SERVICES The facility must provide or obtain preventive and general medical care. This STANDARD is not met as evidenced by: Based on interview and record review the facility failed to provide mammograms for 2 of 3 sampled clients (1&3) that were over 40 years old. Findings: 1. According to the client's face sheet, Client 1 was admitted to the facility on 1 1/2/87, with diagnoses that included severe mental retardation. The record review for Client 1 was conducted on 12/4/08 at 12:00 P.M. Client 1 was over 40 years old and a recent mammogram result was not available in the record. The semi-annual health review completed by the facility's registered nurse indicated that Client 1 was due for her mammogram screening. The registered nurse was interviewed at that time. She acknowledged that the mammogram i screening was overdue since the client last had a mammogram in '04. 2. According to the client's face sheet, Client 3 was admitted to the facility on 9/1/82, with ID PREFIX TAG W130 W322 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) The facility shall provide or obtain preventive and general medical care. Mammogram's have been scheduled for Client 1 and Client 3 by the QMRP. The RN shall ensure that annual mammogram's are completed. The Director of Residential Services shall monitor through random quality assurance client record reviews. (X5) COMPLETION DATE L2/10/08 diagnoses that included severe mental ; retardation. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID:DU2G11 Facility ID: CA090000123 If continuation sheet Page 2 of 3 .DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 12/11/2008 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETEDA. BUILDING 05G952 BWING 12/05/2008 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS. CITY, STATE, ZIP CODE , „,„,,.. ,,_..-_ 6433 FLAMENCO STREET LA COSTA HOUSE CARLSBAD, CA 92008 (X4) ID PREFIX TAG W322 W390 SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION) Continued From page 2 The record review for Client 3 was conducted on 12/4/08 at 3:00 P.M. Client 1 was over 40 years old and a recent mammogram result was not available in the record. The semi-annual health review completed by the facility's registered nurse indicated that Client 3 was due for her mammogram screening. The registered nurse was interviewed at that time. She acknowledged that the mammogram screening was overdue since the client last had a mammogram in '04. 483.460(m)(2)(i) DRUG LABELING The facility must remove from use outdated drugs. This STANDARD is not met as evidenced by: Based on observation and interview the facility failed to remove an expired medication from use. Findings: Drug storage was conducted on 12/5/08 at 8:00 A.M. with the Qualified Mental Retardation Professional (QMRP). The home's first aid kit contained an outdated tube of triple antibiotic ointment. (6/08) The QMRP also observed the date on the tube as 6/08, and acknowledged that it was expired. ID PREFIX TAG W322 W390 PROVIDER'S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) The facility shall remove from use outdated drugs. The QMRP has thrown out the outdated tube of triple antibiotic ointment. The RN shall review medications and drug storage areas on a monthly basis and the pharmacist shall review the medications and drug storage area on a quarterly basis. The Director of Residential Services shall monitor for continued compliance through random quality assurance reviews. (X5) COMPLETION DATE 12/04/08 FORM CMS-2567(02-99) Previous Versions Obsolete Event ID: DU2G11 Facility ID: CA090000123 If continuation sheet Page 3 of 3 AGENDA ITEM # c: Mayor City Council ' City Manager From: <lsohlson@yahoo.com> To: <Council@[205. 142.1 09. 13]> CityClerk Date: 02/09/2009 8:15 PM . Subject: CITY OF CARLSBAD | CONTACT US A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: I want you to know that I approve of the city's decision to support TERI by providing grants. I am also embarrassed by the ignorance and prejudice displayed by the vocal minority who are opposing the group home in Bressi Ranch. They do not speak for me and I live in that community. The vocal minority group who oppose the TERI home believe they have found a legal loophole. They plan on presenting this at the City Council meeting tomorrow night. I am unable to attend this meeting, but am forwarding a copy of the minority group's planned approach to the City Council. Personally, I would like to see this issue put to rest and TERI welcomed into the community. "After reviewing the application and agreement between TERI, Inc. and the City of Carlsbad, it appears that the City and TERI are in breach of contract. Please join us at the City Council Meeting taking place this Tuesday, February 10, at 6pm and demand that the City abide by the law and properly enforce their agreement. According to the Community Development Block Grant (CDBG) application and the approved Carlsbad Housing and Redevelopment Plan, the money awarded to TERI is intended to provide oaffordable housing,o which includes investing in a neighborhood needing omoderate or substantial rehabilitation.6 The upscale, million dollar property purchased by TERI does not need rehabilitating, nor does the new community in which it resides. In short, the home on Alverton Drive purchased by TERI does not meet CDBG objectives. If TERI ofails to comply with any term(s) of the award,ao 6...this Agreement may be suspended or terminated,6 at which point there would be a reversion of assets, requiring TERI to transfer any accounts receivable attributable to the use of the CDBG funds to the City as well as dispose of the property in a manner that results in the City being reimbursed in the amount of the current fair market value of the property. Any changes to this agreement require prior written approval of HUD. We are on the City Council Agenda to speak. Our formal presentation will be ten minutes in length. Anyone wanting to speak, will be allowed five minutes; however in order to speak, you must fill out a speaking request form. Please fill out a speaking request form even if you are not sure about wanting to speak. You can always change your mind. We have rights. We need your help in making sure our rights are protected. Sincerely, Dana Matas" Lynette Ohlson Carlsbad, lsohlson@yahoo.com Mozilla/5.0 (Macintosh; U; PPC Mac OS X 10_5_6; en-us) AppleWebKit/525.18.1 (KHTML, like Gecko) Version/3.1.2 Safari/525.20.1 75.3.204.1 From: <yvetteht@hotmail.com> To: <Council@[205.142.109.13]> Date: 01/07/2009 10:41 PM Subject: CITY OF CARLSBAD | CONTACT US A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: copy of email sent to Bressi Ranch HOA, I am writing this email because I am shocked and saddened about the way your community members are reacting to the TERI group home. I am a mother of 3 year old twins on the Autism Spectrum and my heart sank when I saw the ignorance and lack of tolerance of the men living in that home. You should do some research and learn about what Autism really is. The number of children especially boys being diagnosed with this disorder is staggering u 1 in 150. Where are all of these boys supposed to go when they grow up? These men are not violent or sex offenders, what is the objection. Why should they inform the HOA that they are moving in, they have done nothing wrong and have a right to live a comfortable life. It does not matter that they around kids, they are not child molestors, they just have a neuro-biological disorder. I would never think to let my HOA know that I am moving in with two kids on the spectrum. If I lived in your community I would be very angry and offende! d by this reaction. I am sure that there are some members in your community that are affected by this disorder; I can/Et imagine how they feel. In the next HOA meeting you should hand out information on Autism so that you and your members can make EDUCATED comments, because from what I saw on the news cast this evening it seems Bressi is stuck in the dark ages. Yvette Soto Chula Vista, CA 91911 yvetteht@hotmail.com Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 6.0; SLCC1; .NET CLR 2.0.50727; Media Center PC 5.0; .NET CLR 3.0.04506; lnfoPath.1) 72.220.116.9 Page 1 of 2 Council Internet Mailbox - Fw: Group Home Bressi Ranch! From: "roberta van hise" <bobbevh@sbcglobal.net> To: <Council@ci. carlsbad. ca.us> Date: 01/07/2009 4:32 PM Subject: Fw: Group Home Bressi Ranch O.K ...... I got a little 'nasty'! ----- Original Message — From: roberta van hise To: Editor N.C. Times Sent: Wednesday, January 07, 2009 3:35 PM Subject: Group Home Bressi Ranch I watched comments being made by folks who live in Bressi Ranch regarding the group home for mentally disabled young men the other night on the local news. I also read your article on 1/6/09. As the mother of a son born disabled, I was shocked, hurt and so sorry for these people who have such a narrow view of life. I'm happy their children were born 'normal', but I want them to know we consider our son a blessing. We were tennis coaches for a Special Olympic tennis team for many years. We have been close to so many who suffer from various disabilities. They and their families have become our friends. Some comments from the neighborhood.. .."fear residents of the proposed group home would escape their facility" ..... really? They aren't incarcerated, this will be their home and they will come and go in the community to their jobs and activities just like you. I'm very impressed with their ability to make use of public transportation. "Hurt neighborhood children...." Go meet them and you will find them to be loving gentle people who are much less likely to 'hurt' your children then the average population. Also a comment... ."engage in inappropriate behavior" ...... I think their behavior is superior to that of an average teenager! We've often recruited high school age kids to come help with Special Olympics. Know what happens, they are blessed! It's a joy to watch them interact with people who are 'different'and so special. Thousands of 'normal' people help with Special Olympics events all over the world. Why don't you who live in Bressi Ranch, you might learn something. Isn't the mantra of the day 'equality for all'? But not for the mentally file://C:\Documents and Settings\Klinb\Local Settin2S\TemtAXP2rnwise\4964D90FGW- n?/i n/?nno Page 2 of2 disabled? If any of you Carlsbadians happen to be at the Dove Ln. library, say hello to my son, his name is Steve. He's worked there for over 7 yrs. and spends a lot of time in the children's area putting books on the shelf. You might want to ask the other employees if they think he's fit to be a part of society! Again, I feel so sorry for you, and I wouldn't live in your neighborhood if the home was given to me! Roberta Van Hise Oceanside, CA 732-0548 file://C:\Documents and Settings\Klinb\Local Settings\TemD\XPsrDwise\4964DQOFGW- From: <bobbevh@sbcglobal.net> To: <Council@[205.142.109.13]> Date: 01/07/20094:24 PM Subject: CITY OF CARLSBAD | CONTACT US A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: Bressi Ranch I'm a parent of a mentally disabled son and was horrified to hear the comments made by the Bressi Ranch residents. They obviously have never had close contact with this special population. We consider our son a blessing and have had many years of joy coaching a Special Olympic tennis team. Our son is a city employee and has worked at the Carlsbad Dove Ln Library for over 7 yrs. I do hope you won't be persauded by ill-informed people who believe in discrimination of this sort. I am going to forward a letter I wrote to N.C. Times. Roberta Van Hise Roberta Van Hise Oceanside, CA bobbevh@sbcglobal.net Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 5.1; {9035F43E-F681-D1DB-25EE-E27DC79E6BBF}; YPC 3.2.0) 76.212.176.171 From: <sglidden@workplacepublishing.com> To: <Council@[205.142.109..13]> Date: 01/06/2009 11:52 AM Subject: CITY OF CARLSBAD | CONTACT US A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: I am a 30-year resident of Carlsbad and the mother of a 25-year-old autistic young man. I saw the Channel 7 report last night on the Teri Home planned for Bressi Ranch. I am ashamed and embarrassed for my community at the sight of these weeping and ignorant people protesting the possibility that people different from themselves could be allowed to live among them. I have fought this discrimination toward my son all of his life. My son wouldn't ever be remotely capable of approaching the 6obscene6 and odamagingo behavior of Ms. Benson and Ms. Matas; nor the all cap screaming email on the Channel 7 blog from another resident terrified of the aedevelopmentally disabled/E; implying that a non-profit organization is trying to make money off this effort. Even worse, the oexcess of granite countertops and stainless steel appliances^, surely that is not what aedevelopmentally disabled/E people deserve. This behavior is ignorance, discrimination, arrogance and pathetic. I have struggled ! mightily to find decent housing for my son who is gainfully employed, a taxpayer, kind to people and animals, likes to watch "House Hunters on HGTV" dreaming of the day he can have more than a shabby apartment in a bad neighborhood that will rent to a low-income person. People wonder how the ethnic cleansing horrors that we see in other nations can be allowed to happen. This is how. People such as these. Please let me know what I can do to help you in the effort to ensure that Teri Inc., is allowed to proceed with their plans Stephanie Glidden 4039 Sunnyhill Drive Carlsbad, CA 92008 USA sglidden@workplacepublishing.com Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 6.0; SLCC1; .NET CLR 2.0.50727; Media Center PC 5.0; .NET CLR 3.0.04506; .NET CLR 1.1.4322) 71.154.212.243 From: "Daniel M. Fox" <danielmfox@yahoo.com> To: <Dfoun@ci. carlsbad. ca.us> CC: <council@ci. carlsbad. ca.us> Date: 12/18/2008 8:39 AM Subject: TERI House group home Ms. Fountain, Just wanted to add my 2 cents to the "other" pile: I support the TERI group homes and the concept of main streaming. I find the fear being stoked by certain members of the Bressi Ranch community to be repugnant. To equate mental disability with pedophelia and other dangers to children is disgusting. While I do not live in Bressi Ranch (and will now seriously reconsider any idea to do so given the thought process of some of its residents), I have somehow ended up on the e-mail distribution list putting forth a "call to action". So, I am responding to that call: these people should be ashamed of themselves and be thankful that no one in their family has ever been mentally disabled. It's about basic human dignity, folks. Good luck with the mob. You have my backing - as do the council members. - Daniel M. Fox, esq. Xana Way C'bad 92009 Page 1 of 1 Council Internet Mailbox - Bressi Ranch Group Home, TERI House From: "Cherine Rossman" <the_rossmans@sbcglobal.net> To: <council@ci.carlsbad.ca.us> Date: 12/16/2008 12:15 PM Subject: Bressi Ranch Group Home, TERI House To Whom It May Concern: I became aware of this issue today. I'm sure you have received many complaints from Bressi Ranch residents but this is not one of them. I am disgusted by the rants of these homeowners and their Nazi-like discrimination. This is still America, correct? As long as this home is set up and functions appropriately there is no just cause for their blatant discrimination. I'm sure they would have no problem with the home being set up in Carlsbad's Barrio or conveniently shuffled to Vista where they didn't have to see it. And I'm also sure we wouldn't hear at least a public outcry if the home was for underprivileged minority youths. Please do what is just and fair for everyone; not just the bitter people who overpaid for their homes in Bressi Ranch and use their children to hide behind their prejudice. Cherine Rossman, Carlsbad resident and home owner since 1992. file://C:\Documents and Settings\Klinb\Local Settines\TernD\XPgrnwise\4947QRr>?rTW- 09/1 n/onno 2. Council Internet Mailbox - Re: $1.3 Million Group Home in Bressi Ranch From: Gregory Lewis <rotnscots@sbcglobal.net> To: <michael.carrier@asm.ca.gov>, <assemblymember.garrick@assembly.ca.gov>, Council Internet Mailbox <Council@ci.carlsbad.ca.us>, Manager Internet Email <Manager@ci.carlsbad.ca.us>, Ron Ball <Rball@ci.carlsbad.ca.us>, <bill.horn@sdcounty.ca.gov>, <candyce.yee@sdcounty.ca.gov>, <arron.bone@sen.ca.gov>, Debbie Fountain <Dfoun@ci.carlsbad.ca.us> Date: 01/26/2009 9:41 AM Subject: Re: $1.3 Million Group Home in Bressi Ranch I guess you still didn't address the question as to why the City spent the entire grant for 1 house. You were not under any obligation to spend all of it. That is the problem with government in general. If it is there I must spend it. — On Mon, 1/26/09, Debbie Fountain <Dfoun@ci.carlsbad.ca.us> wrote: From: Debbie Fountain <Dfoun@ci.carlsbad.ca.us> Subject: Re: $1.3 Million Group Home in Bressi Ranch To: michael.carrier@asm.ca.gov, assemblymember.garrick@assembly.ca.gov, "Council Internet Mailbox" <Council@ci.carlsbad.ca.us>, "Manager Internet Email" <Manager@ci.carlsbad.ca.us>, "Ron Ball" <Rball@ci.carlsbad.ca.us>, "Gregory Lewis" <rotnscots@sbcglobal.net>, bill.horn@sdcounty.ca.gov, candyce.yee@sdcounty.ca.gov, arron.bone@sen.ca.gov Date: Monday, January 26, 2009, 9:18 AM Mr. Lewis and other interested parties. Thank you for your letter. Attached is a response on behalf of the City of Carlsbad. Sincerely, Debbie Fountain Housing and Redevelopment Director City of Carlsbad 2965 Roosevelt Street, Suite B Carlsbad, Ca. 92008 (760)434-2815 dfoun@ci.carlsbad.ca.us >» Gregory Lewis <rotnscots@sbcglobal.net> 1/22/2009 7:31 AM >» I am very disappointed in how the City of Carlsbad is spending taxpayer dollars without oversight. With the median home price in Carlsbad at less than $500,000, how is it that the City gave Teri Inc. $800,000 to buy a group home. Since Teri also got $500,000 from the federal government, that is $1,300,000 to buy a home where the prices are below $500,000. Why didn't they buy two homes, or why didn't the City give them a lesser amount and then have some left to award to another recipient? This just makes no sense. The attached letter addresses additional concerns and I hope you will read and consider it. This is not going away easily. file://C:\Documents and Settinas\Klinb\Local Settings\Temn\XPorr,wkp\dQ7r>8^Fr;w- January 12, 2009 A Dear City Official, This letter is to inform you of our community's outrage that the City of Carlsbad awarded an $800,000 Community Development Block Grant to TERI, Inc., in combination with $600,000 from the state, to establish an adult residential facility at 6205 Alverton Drive in Bressi Ranch, serving four developmentally disabled men, without any regard to how that money would be spent to benefit both the city of Carlsbad and the people the grant was intended to serve. Following is a list of our concerns which we hope will lead you to investigate this matter further. 1. Wasteful use of taxpayer money: Given the financial state of emergency California is in, the City must hold non-profit organizations who are awarded money by the government accountable for spending our tax dollars wisely. Spending over $1.4 million of taxpayer money for an adult facility in an upscale neighborhood is an outrageous use of funds by the city and by a non-profit, charitable organization. TERI could have easily bought two homes in less expensive neighborhoods, thereby serving twice as many disabled individuals. Being "fair" to people who require government financial assistance should not include using taxpayer money to buy into an expensive neighborhood far beyond the financial ability of the vast majority of Americans. Although the City says that TERI has a right to purchase a home wherever they wish, we feel that the City had the right and responsibility to conduct cost-benefit and impact analyses before providing these types of funds. The City also should have mandated provisions and safeguards surrounding the home TERI purchased to ensure taxpayer money was used to maximize the benefit to both Carlsbad and the developmentally disabled. If TERI is to qualify for such funds in the future, they should be asked to sell the property in question and use the funds to buy two houses; thereby serving more developmentally disabled individuals. 2. Inappropriate site: Bressi Ranch was designed as a high-density, pedestrian, family- friendly neighborhood with strict CC&Rs which forbid the use of any property for commercial purposes. While the lines are blurred as to whether TERI is a business because of its non-profit status, they still run themselves like a business and will bring into this community the same issues any other business would bring (i.e. traffic, safety concerns, parking issues, etc.) The area of Bressi Ranch where the property in question resides is the densest of the various single-family-home neighborhoods. Children commonly play on the sidewalks, in the streets, and even in front of the property in question. The City played a role in attracting young families to this neighborhood; thus there is an expectation that the City work to maintain the safety of the homeowners and protect their investment, particularly during a time of such economic instability. Specifically, our concerns around these two issues are as follows: a. Safety of children & others: Most TERI group homes are in more rural areas without CC&Rs, where they are separated by more land, where putting up fences is more typical, and where neighborhood children aren't playing directly in front of the home. The particular home purchased by TERI is on the perimeter of the neighborhood and has a larger backyard; however, the front yard has very little space between it and the homes on either side of it. Additionally there is very little space for parking. One has to question why TERI wishes to place an adult facility here at all. While TERI will tell you that they plan to house high functioning autistic men in the home, they legally will have the right to house individuals who suffer from a wide range of mental disabilities, from mild to severe, and in fact get paid more from the government by serving the more severe cases. It is in TERI's financial best interest to work with more severely disabled individuals. How can the homeowners in Bressi Ranch feel confident about their children's safety given this fact? TERI can say anything they want to curb our concerns but they are legally allowed to place anyone they want in that home. Another astonishing fact is that if any of the individuals placed in that home have committed a violent or sexual crime against children, the homeowners would never know. The mentally disabled cannot be tried for such crimes because of their disability; thus they cannot be convicted and made to register with the state under Megan's Law. b. Greater negative impact on home values than in a rural areas: Placing this type of group home in a high-density neighborhood has a far greater negative financial impact on home values than placing it in a rural neighborhood with larger lots and no standardized requirements of construction, landscaping, and maintenance. We have already seen the devastating financial impact this home will have. The buyer of the home directly adjacent to the home in question pulled out of escrow just TWO DAYS prior to closing because he found out that TERI, Inc. had purchased the house next door. This buyer walked away from a non-refundable deposit as well as the money they had already spent to do renovations. This financial loss will not only be felt by homeowners but also by the City in lost property tax revenues. Bressi Ranch residents believed the stricter CC&Rs and Homeowners Association would help protect their home values, as well as provide a safe environment for their families. Yet we're told that that TERI may be essentially exempt from these requirements if those requirements aren't in the best interest of the disabled they house there. We understand that the Fair Housing Act allows for this; however, had the City provided more oversight on how the money was spent, the City could have encouraged TERI to purchase a home in a more appropriate location. 3. Failure of open communication and transparency: We understand that legally the City can not inform us of TERI moving into the neighborhood; however, we believe that the City could have encouraged better communication on the part of TERI to inform and educate the community thereby providing a smoother transition for all parties involved. The Homeowners Association was not even informed about the plans for the property in question until after the home had closed escrow; and even then, we only found out because the home next door fell out of escrow when the potential buyer did some research on the deed next door. In short, we found out on accident. This lack of transparency isn't good for the occupants of the TERI home nor for the surrounding residences. Many of those criticizing us for our legitimate concerns have tried to "shame" us into submission. Let us be very clear. This is not about autism or discrimination against people with autism—this is about the City using common sense when using taxpayer funds. You don't spend $1.4 million to house four individuals when you could have spent the same amount to house 12; and you don't build a dense community of young families only to tear it down with the addition of businesses that pose potential safety risks to children. At a meeting between the Bressi Ranch Home Owners and members from the City Council held on Monday, January 5, where more than 100 residents came out in concern, the homeowners of Bressi Ranch learned that the City of Carlsbad basically handed TERI a blank check. Their due- diligence consisted of one phone call to one house. No one drove out to the homes for inspection. No one reviewed police records to determine the safety risk of such a home. And no one provided TERI with any provisions, oversight or safeguards on how the money would be spent to benefit the community as well as the people the grant was intended to serve. The City of Carlsbad has done well by the Bressi Ranch community. Beyond the tax dollars you enjoy, the community has established low-income housing, a Boys and Girls Club, and senior center. We pray that you will do right by Bressi Ranch and all the taxpayers of Carlsbad by asking TERI to sell the property in question so they can use the money to buy two houses in a more rural area of Carlsbad, helping more developmentally disabled individuals. Sincerely, Concerned Taxpayers of Carlsbad of Carlsbad Housing & Redevelopment Department January 26, 2009 Dear Mr, Lewis and Concerned Citizens of Carlsbad: Thank you for your correspondence dated January 22, 2009 regarding the TERI Home in Carlsbad and the City of Carlsbad's financial contribution to assist with the acquisition of the property. The City of Carlsbad has received correspondence from a number of residents who have both supported as well as opposed the City's actions on this matter. White there may be disagreement on how the public good is best served or whether or not an action is fair and responsible, we hope the citizens of Carlsbad will agree that a difference of opinion does not equate to indifference or incompetence by the elected officials and/or staff of the City of Carlsbad, or others, It is simply a difference of opinion. It is understood that there is probably little the City could do at this point to change the opinion of residents who do not agree with the City's actions/decisions on this matter. However, I hope with the following information there will at least be a better understanding of the City's decisions regarding this matter. TERI received Community Development Block Grant (or CDBG) funds through a public allocation process to assist them in acquiring another home in Carlsbad that could be used to house up to six (6) clients with autism/developmental disabilities. The CDBG funds are provided to the City by the federal government to assist communities in meeting the needs of low income households of all types, including those with special needs such as the disabled. These funds can be used for this purpose only. The City is unable to use these funds for general city services or projects, unless that service/project specifically benefits low income persons only. These are not funds that could otherwise be used by the State of California or the City of Carlsbad for other purposes, such as operations of schools, libraries, fire stations, police services, maintenance of roads, etc. The specific funds provided to TERI also could not be used for operating costs for any other non-profit organization. They were required to be used specifically for an affordable housing project. There was no other application or other eligible project for these affordable housing funds at the time funds were awarded to TERI, It should also be noted that there was no other project denied funding because of the funding approved for TERI, and the City believed the funding request to be reasonable based on its experience in providing affordable housing opportunities for low income households within Carlsbad, There is an application process for the CDBG funds which begins in November/December of each year for the following program year. The application process is a lengthy public process that includes review by a Citizens Advisory Committee, several public hearings before the City Council, and general public notices on intended use of funds. In accepting the funds, the City agrees that it will not engage in any discriminatory activity and will make every effort to advertise availability of the funds and encourage 2965 Roosevoit St.. Sto. B » Carlsbad, CA 92008-2397 - {760} 434-2810/2811 • FAX {760} 720-2037 organizations to apply for funding to meet the diverse needs of the low income populations within the community. Each project application is evaluated by the Advisory Committee, project applicants are interviewed, and then a recommendation is made by the Advisory Committee on projects to receive funding allocations, Public hearings are also held for community input before a decision is made by the City Council. In terms of land use, the City does not believe the lines are blurred as to whether the TERI Home is a commercial or residential use. California Health and Safety Code; Section 1566.3 states the following: "(a) Whether or not unrelated persons are living together, a residential facility that serves six or fewer persons shall be considered a residential use of property for the purposes of this article. In addition, the residents and operators of such a facility shall be considered a family for the purposes of any law or zoning ordinance which relates to the residential use of property pursuant to this article. (b) For the purpose of ail local ordinances, a residential facility that serves six or fewer persons shall not be included within the definition of a boarding house, rooming house, institution or home for the care of minors, the aged or the mentally infirm, foster care home, guest home, rest home, sanitarium, mental hygiene home, or other similar term which implies that the residential facility is a business run for profit or differs in any other way from a family dwelling," The above means that the use must be considered residential (not a business) and the residents considered a family. The City would be violating the law if the TERI home were to be treated as anything other than a family dwelling, just like every other home within Bressi Ranch. These laws also apply to the Bressi Ranch HOA and related CC&Rs. The home in Bressi Ranch was selected by TERI for many of the same reasons that the current residents purchased homes within the community - quality of homes, environments., proximity to community resources and activities. According to TERI, the fact that the property is new and ready for occupancy means that no upgrades or additional landscaping is needed which would have added additional cost. Because there are no additional costs involved with the selection of the home in Bressi Ranch, the purchase was more financially feasible than other properties within Carlsbad. TERI has indicated that the home will be well maintained inside and outside, and TERI as well as its residents will comply with all HOA guidelines and related CC&Rs, No six foot or eight foot wall will be built around the house, as some Bressi residents have heard and expressed concern. The residents within the TERI home will not be criminals, drug abusers, or sex offenders, They will be high functioning individuals who will either attend public schools or a work program during the week, and often stay with their birth families on weekends. They will be supervised by professional staff 24 hours per day, TERI and its programs are not new to the City of Carlsbad. TFRI has had another group home in the La Costa Area of Carlsbad for approximately 27 years. There has been no indication to date of any reduced home values as a result of the group home operated by TERt. The City has also had no experience with negative incidents related to safety or any other concern with the La Costa home. The home has existed as a good neighbor and the residents have well-integrated into the community. TERI has an excellent reputation for providing quality sen/ices to the disabled population. The City had no indications otherwise that would have caused concern related to the investment or home location. As you are already aware, it would have been discriminatory and illegal for the City to notice property owners of the establishment of the group home by TERI. It would also have been discriminatory and illegal for the City and others to require TER! to purchase a home in an alternate neighborhood or deny them the right to purchase the home in Bressi Ranch. While the City agrees that there may have been a missed opportunity by TERI to better integrate within the community by communicating earlier in the process, the City does not believe that there was any intentional deceit. TERI has not had this type of negative reaction to any of Iheir 10 group homes or in their history of operating their programs for the disabled. Therefore, both the City and TERI were caught off-guard by the outrage demonstrated by many Bressi residents. It has been ar» opportunity of education, however, that both the City and TERI will learn from and tn/ to improve upon in the future. In summary, 1 hope the above information is helpful. It is understood that you and others disagree with the City's actions to provide CD8G funding and allow TER! to purchase a home in Bressi Ranch. However, the City does not believe it would be appropriate or legal to request that TERI sell the home in Bressi Ranch and purchase one or more properties at another location, or threaten future funding. TERI does not want to move. They hope to be able to work with the community to create a better understanding of the type of residents assisted at their home and the quality of life desired for those residents. Based on comments and feedback provided by supporters of the TERI home and those with personal experience, the City believes TERI residents wiSI be well-adjusted individuals who just need some help to be the best that they can be. We hope that the Bressi residents will give its new residents the same chance to succeed and integrate into the community as you have wrth other new neighbors. If you would like any additional information regarding this matter, please do not hesitate to contact my office again. '"Sincerely, M Mi' L ' A, -N 4 -::LA:4y./ \Cl^^"> ^6-0 DEBBIE FOUNTAIN Housing and Redevelopment Director r>-frWv? ,* Page 1 of 2# Council Internet Mailbox - Re: CITY OF CARLSBAD | CONTACT US From: Debbie Fountain To: Council Internet Mailbox; randy@saturnlitho.com Date: 01/15/2009 9:03 AM Subject: Re: CITY OF CARLSBAD | CONTACT US Attachments: Bressi Ranch TERI Group Home FAQs.pdf Dear Mr. Johnson. Your e-mail regarding the TERI home was forwarded to my office for a response. Your opinion on this f\ matter has been duly noted. In response to your specific inquiries regarding the funding, the following ** information is provided. TERI received Community Development Block Grant (CDBG) funds from the City of Carlsbad to assist them in acquiring another home in Carlsbad that could be used to house up to six clients with autism/developmental disabilities. CDBG funds are provided to the City by the federal government to assist communities in meeting the needs of low income households of all types, including those with special needs such as the disabled. These funds can be used for this purpose only. They can't be used for general city services or projects, unless that service/project primarily benefits low income persons. There is an application process for these CDBG funds which begins in November/December of each year for the following program year. The application process is a lengthy public process that includes review by a Citizens Advisory Committee, several public hearings before the City Council, and general public notices on intended use of the funds. In accepting the funds, the City agrees that it will not engage in any discriminatory activity and will make every effort to advertise availability of the funds and encourage organizations to apply for funding to meet the diverse needs of the low income populations within the community. TERI was, and remains, an eligible applicant that submitted a project for funding that meets both national and local objectives for the CDBG program. The funding provided to TERI had to be used to assist low income persons, and the majority of the funds were specifically required to be used on housing for low income households. These funds have very strict regulations for use. Again, they can't be used for other general city purposes (such as park maintenance, library services, road maintenance, etc). The City Council did approve the Citizen Advisory Committee recommendations to allocate the CDBG funds to the TERI home in April, 2008. This project together with 14 other programs which provide assistance to low income persons received funding for the 2008-09 program year. The vote for the allocations was 4 to 1 in favor. Mayor Lewis, Mayor Pro Tern Kulchin, Councilmember Hall and Councilmember Nygaard voted in favor. Councilmember Packard voted no. However, he noted his support for the Committee-recommended allocations. He did not support the additional recommendation of the Mayor to provide General Fund Council Contingency for the operation of Fraternity House. This recommendation was supported by the other Council members. I have attached a "Frequently Asked Questions and Answers" sheet regarding the TERI Home purchase for additional information purposes. Let me know if you would like any additional information. file://C:\Documents and Settina<5\K1inh\T.nr.fll Page 2 of 2 Sincerely, Debbie Fountain Housing and Redevelopment Director City of Carlsbad 2965 Roosevelt Street, Suite B Carlsbad, Ca. 92008 (760)434-2815 dfoun@ci.carlsbad.ca.us >» <randy@saturnlitho.com> 1/12/2009 3:37 PM »> A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. ********************************************** FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE.********************************************** Below, please find the information that was submitted: Dear council members I would like to know why you felt it necessary to give away $795,000 of our hard earned tax money to TERI Inc. for a group home? We have other serious problems facing us in this tough economy. Sometimes you just have to say no. Was this voted on by the council? Was was the vote outcome? We need a city council that is business smart and makes good business decisions, please don't waste anymore of our money. I would appreciate a response from each one of you and how you voted. Randy randy Johnson 5 randy @saturnlitho .com Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 5.1; .NET CLR 1.1.4322; .NET CLR 2.0.50727; .NET CLR 3.0.04506.648; .NET CLR 3.5.21022) 75.32.229.168 file-//C:\Documents and SettinPs\Klinh\T,ocal SettincMTpmrAYParnwicpUQ^FFRni nw_ no/1 nnnna TERI Group Home Bressi Ranch Frequently Asked Questions and Answers The City of Carlsbad has been contacted by some residents with questions about the recent purchase of a Bressi Ranch home by the Training Education and Research Institute (TERI) to serve six developmentally disabled adults. To help ensure the community has accurate information, the City has prepared this Questions &Answers document. Who is TERI and what do they do? TERI, Inc. Phone: 760-721-1706 251 Airport Road Fax: 760-721 -9872 Oceanside, CA 92058 E-mail: inFo@teriinc.org The Training Education and Research Institute (or TERI) is a nonprofit organization that provides services to individuals with developmental and learning disabilities. TERI is a well respected organization that was established and has been operating since 1980. The organization has enjoyed substantial support throughout North County, and numerous families from Carlsbad have utilized their services for many years. TERI has owned and operated a single family group home in the La Costa area of Carlsbad for 27 years. The organization currently administers residential programs in 10 group homes and operates a day program for 180 adults with developmental disabilities. Residents in TERI's programs receive "active treatment" in both their living environment and day programs. Active treatment supports the client in the activities of daily living through teaching, modeling and assisting. Clients attend a day program Monday through Friday from 9:00am to 3:00pm with TERI providing transportation to and from this activity. What funding was provided by the City and why? TERI applied for a Community Development Block Grant or "CDBG" loan from the City of Carlsbad in February 2008 to help them acquire another home in Carlsbad that could be used to house up to six clients with autism and developmental disabilities. Within the application, TERI noted that persons with developmental disabilities have a need to live as normally as possible, and residential programs of no more than six individuals are particularly effective in building a sense of family and community. At the time of application, TERI had not yet selected a home to purchase. It was not possible to identify a property at the time due to the substantial processing time required before TERI would have received confirmation of project funding. TERI, however, did provide information on the type of home that would be suitable for the noted residence. The ideal property was a single family home with 4 to 5 bedrooms and approximately 3 bathrooms. The selection and purchase of the specific home was made after the funding was awarded by the City, which is acceptable under the CDBG program. CDBG funds are provided by the federal government to assist communities in meeting the needs of low income households of all types, including those with special needs such .as the disabled. The application process for these funds begins in November/December of each year for the following program year. For example, funding requested in December 2008 will not be available to the applicant until approximately August/September of 2009. The application process is a lengthy public process that includes review by a Citizens Advisory Committee, several public hearings before the City Council, and general public notices on intended use(s) of the funds. In accepting the funds, the City agrees that it will not engage in any discriminatory activity and will make every effort to advertise availability of the funds and encourage organizations to apply for funding to meet the diverse needs of the low income populations within the community. TERI is an eligible applicant that submitted a project for funding that meets both national and local objectives for the CDBG program. The CDBG Advisory Committee, which is made up of a resident from each quadrant of the City, a Housing Commissioner, Senior Commissioner and Planning Commissioner, recommended and City Council approved a loan of $795,000 for TERI to acquire a home in Carlsbad. TERI was required to demonstrate that it is using matching funds of one dollar for every two dollars of City CDBG funds. TERI also received approval of a loan from the federal Department of Housing and Urban Development or "HUD" for $582,900 to assist in the purchase and improvements needed to utilize and license the property as a group home with the State of California. Is a Group Home allowed in a residential neighborhood? Is a notice required to the neighbors? State law and the City of Carlsbad's Zoning Ordinance both allow residential care facilities (or group homes) serving six or fewer persons in a residential zone. For the purposes of determining the appropriateness of the group home occupying a single family home, "family" is defined in the Carlsbad Zoning Ordinance (Section 21.04.145) as "a reasonable number of persons who constitute a bona fide single housekeeping unit." The definition includes residents and operators of a residential care facility serving six or fewer persons. Section 21.04.300 of the Carlsbad Zoning Code defines "residential care facility" as "a state authorized, certified or licensed family care home, foster home or group home serving mentally disordered or otherwise handicapped persons, or dependent and neglected children where care is provided on a twenty-four hour a day basis." This use (group home) is permitted without any discretionary permits issued by the City. State law prohibits the City from requiring a permit for such a use as it would be deemed discrimination against disabled individuals. Therefore, there is no public process for approval and/or noticing to neighbors. The use is permitted by right. Because it is comparable to any type of family moving into a single family home, noticing of this specific family type (disabled) would be discriminatory. How was the location selected? Why did the City allow the purchase in Bressi Ranch? After many months of searching for a suitable home, TERI decided to purchase the property at 6205 Alverton Drive (within Bressi Ranch) for approximately $1 million. The price paid was based on a fair market appraisal of the property as of October 7, 2008. Escrow closed on the purchase in late November, 2008. The Group home is currently being retrofitted to meet state requirements and is not yet occupied. Under the Federal Fair Housing Act, it is against the law to direct homebuyers to certain neighborhoods only, make housing unavailable, or deny a dwelling based on race/color, national origin, religion, gender, familial status, or disability. It is also against the law to harass, coerce, intimidate, or interfere with anyone exercising or assisting someone else with their fair housing rights. The City and other parties (including real estate agents) to this transaction would have engaged in a discriminatory practice if it had directed TERI to an alternate neighborhood within Carlsbad and/or another City. Is a $1 million home to serve six people an appropriate use of taxpayer money? TERI operates homes in communities throughout North County. TERI's goal is to house its clients in the communities where their families live or where they have roots. In Carlsbad, it is fairly expensive to provide affordable housing for low income households, especially the disabled. Based on Carlsbad's experience in providing low income affordable housing, it currently costs a minimum of approximately $275,000 to produce a single rental housing unit. If we were to assume that each of these six adults were to be housed separately, the cost is estimated at $1,650,000. The purchase of a $1 million single, large group home is reasonable and appropriate in comparison to the construction of individual units. What laws and government agencies oversee group homes like this? The California Department of Social Services licenses care facilities for persons who cannot live alone but who do not need extensive medical services. The agency ensures community care facilities operate according to applicable laws and regulations (California Health & Safety Code and Title 22 of the California Code of Regulations). Compliance is maintained through unannounced facility inspections, complaint investigations, issuing deficiency notices, consultations, education and technical support. More information is available on the department's Web site, http://wwvv.ccld.ca.gov. If you have questions about licensing and monitoring of group homes, you may contact the San Diego Residential Office for the California Department of Social Services at (619) 767-2300. Ask for the Group Home Duty Worker. What expectations were set forth for operations of the TERI home? The City approved funding for acquisition of property for a group home in Carlsbad to serve up to six (6) persons with autism or developmental disabilities. The property acquired must be used for this purpose for a minimum of 20 years, or the funding must be repaid to the City. The TERI home in Bressi Ranch will serve no more than 6 young adults (approximately 18 to 19 years of age) which are autistic but higher functioning and commonly referred to as intellectually disabled. These adults will not require a high level of support and generally able to contribute to society in a productive way. They are generally higher skilled and could actually live independently. The home, however, gives them an opportunity to live in a family-type setting and more fully develop their social and other house-keeping skills. In selecting the clients to live at the home in Bressi Ranch, TERI intends to identify clients that are compatible with each other and the neighborhood. TERI will be required to obtain a license to operate from the State Department of Social Services. The organization will also be required to obtain a building permit for interior improvements and must comply with the building code. The City, however, does not enforce CC&Rs for Bressi Ranch. Why did TERI representatives not attend the meeting after being specifically invited by the homeowners? Until the night of the meeting, City staff did not know that TERI had been invited to the meeting. Previous conversations with one of the meeting organizers, Jim Benson, had indicated that the homeowners did not want TERI to attend the meeting. They only wanted to express their concerns and requests to the City Council. Staff was actually surprised to hear that TERI had subsequently been invited to the meeting. Following the meeting with the homeowners, staff contacted the Executive Director (Cheryl Kilmer) of TERI to obtain information on their reasons for not attending. The Executive Director indicated that the hostility exhibited by the homeowner representatives during telephone conversations indicated that the meeting would not be productive and that TERI would be more successful in sharing their program plans in much smaller group meetings/settings. TERI will be contacting the homeowners' association to schedule smaller group meetings and invite the homeowners to personally experience their group homes and meet some of the clients. They have a comprehensive team working on an information program, including responses to homeowner questions, and will begin implementing it immediately to address homeowner concerns. What type of developmentally disabled person will be served at the group home in Bressi Ranch? Did the City stipulate that the disabled persons served at this home be at the lowest level of special needs and highest functioning capacity? Within their application for funding, TERI indicated that they would serve up to six (6) autistic and developmentally disabled persons within the group home in Carlsbad. The City agreement with TERI stipulated the noted service. The City did not, however, stipulate a specific level of disability or care because we did not feel this was warranted based on previous experience with TERI and/or actually permitted under non-discrimination requirements/regulations. TERI has publicly stated several times that their intent is to place no more than six (6) high functioning autistic young men within the group home at Bressi Ranch. When selecting clients for a home, TERI has stated that they give serious consideration to the compatibility between residents as well as compatibility with the neighborhood. These young men do not have a high level of support needed and could actually live independently. In fact, some of the young men could even be bound for College. Bressi Ranch residents have expressed concern about persons being served at the home that have "dual diagnosis". At the resident meeting on January 5, 2009, one resident defined "dual diagnosis" as mentally disabled persons who also have drug-addictions. According to the Executive Director for TERI, "dual diagnosis" in their program (and others) refers to persons who have both mental retardation as well as a mental disability. The mental disability is often managed with prescribed drugs and the persons are trained in a manner to assist them to function well with the mental retardation. This type of disabled person, however, will not be residing at the noted home. The clients served also will not be drug addicts, criminals or sex offenders. These are not the type of clients served by TERI. Has TERI applied for a building permit to make home improvements? Is TERI exempt from complying with the building code or the CC&Rs for Bressi Ranch? Can the State regulations supersede the CC&Rs? As of this date (1/6/09), TERI has not applied for a building permit to make home improvements and no improvements are currently being made to the home. TERI is currently working on their plans and does not yet have a schedule for submitting their application for a building permit. TERI has indicated that they will comply with the applicable building codes and will obtain a building permit prior to starting construction on any improvements. When asked if they will comply with the CC&Rs, the Executive Director of TERI indicated that they plan to comply with all applicable rules and to be a good neighbor. The City does not enforce CC&Rs. Therefore, City staff will simply determine if proposed improvements are consistent with the building code before issuing any permits. The Homeowners Association will be required to enforce the CC&Rs. However, they must also comply with non- discrimination and reasonable accommodation laws set forth by the State of California. TERI will apply for a group home operating license through the State of California. The State has its own set of requirements for home improvements required for a group home. This activity is not regulated by the City of Carlsbad. Page 1 of 1 Council Internet Mailbox - TERI Inc. Home at 6205 Alverton Drive, Carlsbad From: "Jim Benson" <jbenson@almargroup.com> To: <manager@ci.carlsbad.ca.us>, <council@ci.carlsbad.ca.us>, <rnusc@ci.carlsbad.ca.us>, "Debbie Fountain" <Dfoun@ci.carlsbad.ca.us> Date: 01/08/2009 9:53 AM Subject: TERI Inc. Home at 6205 Alverton Drive, Carlsbad Attachments: Request for City Council Agenda.doc; Bressi Ranch Letter to City of Carlsbad et al.doc To: Carlsbad City Manager - Lisa Hildabrand Lisa, I am forwarding a formal request to have an item put on the City Council agenda scheduled for January 13. I have attached the formal request and a letter stating the feelings of many Bressi Ranch homeowners. Please reply or call me at the number below to confirm this item will be added. On another note, per the California Public Records Act, the Bressi Homeowners would like to request any and all correspondence between TERI, Inc and the City of Carlsbad, including but not limited to all Council Members, Mayor Bud Lewis, the City Attorney and City Manager dating back at least 2 years. The information shall include all correspondence and not just information and correspondence regarding the property located at 6205 Alverton Drive. Please let me know when these documents will be available for review within the next 10 days. Thank you, Jim Benson Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: l file://C:\Documents and Settings\Klinb\Local Settinss\TemD\XPerowise\4965CDOAGW-... 02/10/7009 January 7, 2009 Lisa Hildabrand City Manager City of Carlsbad RE: TERI Group Home in Bressi Ranch/Request to be placed on 1/13/09 Agenda FAX: 760-720-9461 Lisa, In follow up to a special meeting between Bressi Ranch Homeowners and pro tern Kulchin and Councilperson Packard on Monday, January 5, 2009 I would like to request that our concern be placed on the City Council Meeting Agenda for January 13, 2009. As per Debbie Fountain this request is required in writing. Please consider this letter our formal request. I have attached a letter drafted, which has already been submitted to Carlsbad City Council on January 6, 2009, as documentation of overall Bressi Ranch Resident's outstanding questions, concerns and recommendations regarding this issue. Respectfully, Bressi Ranch Homeowners and your constituents City of Carlsbad Cc Mayor Lewis pro tern Kulchin Councilperson Packard Councilperson Hall Councilperson Blackburn Carlsbad City Attorney DATE: Januarys, 2009 TO: Mayor Lewis, Carlsbad City Council, Carlsbad City Manager, Carlsbad City Attorney FROM: Bressi Ranch Residents SUBJECT: Group home in Bressi Ranch We are appalled to learn that the City of Carlsbad has provided $800,000 (in addition to nearly $600,000 from the federal government) to TERI Inc. to establish a group home on Alverton Drive in Bressi Ranch to serve four, with plans for up to six developmentally disabled men. There are a number of issues with this plan. 1. Wasteful use of taxpayer money: Spending over $1 million of taxpayer money for a group home in an upscale neighborhood is an outrageous use of funds by the city and by a non-profit, charitable organization. TERI could have easily bought two homes in less expensive neighborhoods and served twice as many disabled individuals. Being "fair" to handicapped people who require government financial assistance should not include using government money to buy into an expensive neighborhood far beyond the financial ability of the vast majority of Americans. Although the City says that TERI has a right to purchase a home wherever they wish, we feel that the city has the right and responsibility to conduct cost-benefit and impact analyses before providing the funds. Taxpayers are rightfully angry when they see their tax dollars spent in this manner. 2. Inappropriate site: Bressi Ranch was designed as a high-density, pedestrian- and family-friendly neighborhood with strict CC&Rs. The area of Bressi Ranch where the home is being placed includes the densest of the various single-family-home neighborhoods. Children commonly play on the sidewalks and in the streets. There is an expectation of safety. Given the nature of the neighborhood, the proposed site is inappropriate for several reasons: a. Safety of children & others: TERI serves a broad range of clients who can be a danger to themselves and others, and therefore proposes to put up a front-yard fence to prevent their clients from wandering. However, this is in violation of our CC&Rs and would certainly diminish the ambience of the neighborhood. Most TERI group homes are in more rural areas without CC&Rs, where they are separated by more land, where putting up fences is more typical, and where neighborhood children aren't playing directly in front of the home. The particular home purchased by TERI is on the perimeter of the neighborhood and has a larger lot; however, the interior lots in that area are very small and children frequently play in the front yards and streets. One has to question why TERI wishes to place the home here at all. b. Greater negative impact on home values than in a rural area: Placing this type of group home in a high-density, expensive neighborhood has a far greater negative impact on home values than placing it in a rural neighborhood with large lots and no standardized requirements of construction, landscaping, and maintenance. Two home sales on the same street have already fallen through because of this, and at least one other would have, but it was too late. Bressi Ranch residents paid more to buy into this neighborhood because they believed the stricter CC&Rs and Homeowners Association would help protect their home values, as well as provide a safe environment for their families. Yet we're told that the group home is essentially exempt from these requirements. We have been placed in the catch-22 situation of having a large fence surrounding the property, thus violating the CC&Rs and the ambiance of the community, or allowing group home residents to roam freely around the neighborhood despite the fact that they are supposed to be fenced in. Once again, these problems wouldn't exist if the home were simply placed in a rural large-lot area of town. 3. Failure to protect residents of Bressi Ranch: The city government failed in its most basic responsibility: to protect residents. Our Homeowners Association was not even informed until after the home had closed escrow. The city accepted verbal promises of light-impact use of the property ("only high functioning autistic individuals") yet required nothing in writing. In fact, the permits granted to TERI allow even the highest risk clients to be housed in this group home. Although residents of the group home cannot be assumed to be criminals or sex offenders, there is a reason they 're not allowed freedom of movement. We doubt that it is solely for their own protection. What do we want? We want our children (and ourselves) to be safe, our tax money to be spent wisely, and our home values to be protected to the extent reasonably possible. This means the home cannot be located within Bressi Ranch or other similar neighborhoods. We would like the city to do everything within its power to cause TERI to use the money wisely and build/buy into a rural less-expensive location. If the above were truly impossible, we would like the city to do everything within its power to assure that TERI is legally required (rather than just giving verbal assurances) to limit the residents of this home to those with no proclivity toward criminal or sexual offenses, and no indication that they might be dangerous to others. If this requirement is not possible, then they should be legally required to stay away from all the park areas and the clubhouse/pool facilities at all times. Failure to abide by such legal requirements should be cause for removal of their license to operate the home. This is not about discrimination. Bressi Ranch happily includes a multi-racial, multi-cultural population, affordable housing (condominiums), and soon-to-be-built senior housing and a Boys and Girls Club. It is about public safety, misuse of taxpayer dollars, enforcement of the CC&Rs, and protection of home values in our neighborhood. Carlsbad rightfully prides itself in creating and maintaining a community that is the envy of others. In this instance, however, the City Council really dropped the ball - and the residents of Bressi Ranch are paying the price. 3 Page' °f 2 Council Internet Mailbox - Re: Information on the TERI Inc Grant From: Debbie Fountain To: Jim Benson Date: 01/08/2009 5:15 PM Subject: Re: Information on the TERI Inc Grant CC: Council Internet Mailbox; Manager Internet Email; Robin Nuschy Attachments: AppReviewProcess2009.doc; Application2009.doc; 2009RFP .doc; Funding Plan .doc Hi Jim. I shared some of this information in the fact sheet I distributed to you. However, I thought the attached documents would be helpful for a start. We are currently in the process of accepting applications for the next program year of CDBG and HOME funds. I thought the attached documents would answer most of your questions. If you still have some questions or want additional information after reading the attached let me know and I will forward other related documents. Thanks. >» "Jim Benson" <jbenson@almargroup.com> 1/8/2009 2:37 PM >» Debbie, I would like to gather as much information as possible on the 'Grant' that TERI Inc received from the City of Carlsbad. I am assuming this falls within the California Public Records Act. To begin with I would like the name of the grant. Next, I would like to see information such as who qualifies for this particular grant and why, what the guidelines are from a state and city level, can a recipient do whatever they want with the money (i.e. buy a house), once a city gives a recipient the money, do they have to or should they follow up with them to find out how the money is being spent, does the recipient have a responsibility to keep the city informed as to how they are spending the money. If I should be requesting the information for the California Public Records Act from someone else, please let me know. Thanks, Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL Real Relationships. Real Success. 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: jbenson@cbcworldwide.com | Web: www.cbcworldwide.com ONCORINTERNATIONAL From: Debbie Fountain [mailto:Dfoun@ci.carlsbad.ca.us] Sent: Thursday, January 08, 2009 10:43 AM To: Jim Benson Cc: Council Internet Mailbox; Manager Internet Email; Robin Nuschy Subject: Re: Follow up to Bressi meeting Ok. I saw your recent letter to the City Manager requesting to make a presentation. So, my clarification is unnecessary at this point. But, thanks for responding. >» "Jim Benson" <jbenson@almargroup.com> 1/8/2009 10:32 AM >» file://C:\Documents and Settings\Klinb\Local Settines\Temn\XPprnwise\4Q<W4r8rTW- n?/i 0/9000 Page 2 of2 Debbie, We did agree to give Council time to review this with the attorneys. However, that was three days ago and nothing has been reported back to us. I understand things don't happen very quickly in government, however, we will not allow the Council to put this issue on the back burner for weeks in hopes that it will go away. We will keep this moving forward and we will get more and more Carlsbad residents to back us. The $800,000 grant should not have been given to TERI without a single /- safeguard to protect the rest of the Carlsbad residents or to ensure TERI absolutely maximized the money given to them (in this case buying two homes instead of one). The City Council didn't drive by any of the TERI houses or ask any questions before approving the grant. I don't think the Carlsbad residents want a council that does absolutely no due diligence prior to rubber stamping an issue that involves every other resident in Carlsbad. It was a bad decision that we want corrected. This is a political matter that the City can fix if it really wants to. Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL Real Relationships. Real Success. 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: jbenson@cbcworldwide.com | Web: www.cbcworldwide.com ONCORINTERNATIONAL From: Debbie Fountain [mailto:Dfoun@ci.carlsbad.ca.us] Sent: Wednesday, January 07, 2009 11:28 AM To: Jim Benson Subject: contact Hi Jim. I just wanted to check in with you on the expectations related to follow up on the Monday evening meeting. I heard from Mimi Manzano today that the expectation from the homeowners was for staff/Council to place an item on next week's Council agenda to discuss the TERI Home in Bressi Ranch. I shared with her that my understanding was that the residents accepted the Council's offer to have our attorneys review the issue and determine the City's options at this point. My understanding is that I am to report back to you when the attorney completed his review and we knew what action we might take. We did not have a specific time frame but agreed we would try to do that as quickly as possible. You indicated that I should share the information with you and then you would share with the other homeowners. I believe we discussed the process if the homeowners wanted to make a presentation to the full council, which is to submit a letter to our City Manager (Lisa Hildabrand) and that she would then schedule the matter for a future agenda. Ms. Manzano believes that the expectation was for us to place this matter on next week's agenda and that it should not require a letter from the homeowners. Can you please tell me what your expectation is from the meeting and whether or not you were expecting this matter to be on next week's agenda? Thanks. file://C:\Documents and Settines\Klinb\Local Settines\Temn\XParnwke\4Q^4rsrTW- rn/1 CITY OF CARLSBAD CDBG/HOME PROGRAM APPLICATION REVIEW PROCESS PURPOSE To set forth procedures to be used for allocating the annual City of Carlsbad Home Investment Partnership (HOME) and Community Development Block Grant (CDBG) funds. BACKGROUND Each year the City of Carlsbad is entitled to receive funding from the U.S. Department of Housing & Urban Development through the CDBG Program to finance projects and/or services, which benefit low/moderate income persons/households within the community. The City also receives federal funds through the HOME Program to implement housing activities that benefit lower income households. In response to the City's "Request for Proposals" for the CDBG/HOME Program, the City receives numerous applications for funding from local organizations. In an effort to facilitate the activity selection and funding allocation process, the following procedures have been established for the program. OBJECTIVE The intent of this process is to streamline the CDBG/HOME funding allocation procedures and implement specific proposal evaluation criteria that can be used to assist in the selection of activities for funding on an annual basis. This process describes the CDBG/HOME application process; outlines the review process for activity selection and funding recommendations; and, summarizes the public hearing requirements. A CDBG/HOME Advisory Committee, will be appointed to review and make recommendations to the City Council on funding levels for each of the eligible activities submitted by organizations and/or city departments. PROCEDURES The goal of the City of Carlsbad is to develop a well balanced CDBG/HOME Program that reflects the various needs of its low to moderate income residents, with three primary areas of focus: 1) affordable housing; 2) general social services for lower income persons; and 3) services for children and adults, including the elderly. The following procedures outline the steps to be used by the Advisory Committee and staff of the Housing and Redevelopment Department in selecting activities, which provide for a well- balanced program and in making recommendations for allocation of the funds on an annual basis: 1. Interested persons, non-profit organizations, City departments and others may submit a request for funding on the appropriate application form. A public notice in a local newspaper of general circulation will indicate how to obtain an application and the due date for all proposals. Generally, the application review process will begin in November or December of each year. 2. Upon receipt of proposals/applications for funding, Housing and Redevelopment Department staff will make a determination regarding the eligibility of each proposed project for funding consideration under the program. Requests for funds shall be considered for funding only if the application is complete and demonstrates that the following conditions have been met: APPLICATION REVIEW PROCESS PAGE 2 a. The governing board formally authorized the organization's request for CDBG and/or HOME funds from the City of Carlsbad and authorized official to bind organization into subsequent agreements for CDBG funds; b. The proposed use of funds is an eligible activity, per the Federal regulations for the CDBG and/or HOME program; c. The organization and the proposed activity must not have any outstanding or unresolved findings of violation of the federal regulations governing the CDBG and/or HOME program; d. If applying for CDBG funds, the proposed use of funds meets at least one national objective for the CDBG program, as established by the Federal regulations; e. If applying for CDBG funds, the proposed use of funds meets at least one local objective for the CDBG program, as established by the City of Carlsbad's Community Development Plan; and, f. If applying for HOME funds, the proposed use of funds must be for the purpose of increasing the availability of affordable housing for lower income households. 3. All complete applications, which have met the conditions outlined above, shall be considered eligible for funding consideration and shall continue in the activity selection and funding allocation process. All applications that are deemed ineligible for funding consideration shall receive written notification that the application for funds is ineligible due to a specified reason and will not be reviewed further by staff or the Advisory Committee. 4. The Advisory Committee will consider the needs of lower income Carlsbad residents in developing recommendations to the City Council for the funding of activities which are the "most qualified" to meet those needs. The Committee will consist of seven (7) members and will include the following representatives to be appointed by the City Council: Senior Commissioner, Planning Commissioner, Housing Commissioner, and four citizens-at-large (one from each quadrant of the City). 5. Each eligible application for funds shall be reviewed and evaluated, for ranking purposes, based upon the criteria outlined below. Advisory Committee Members and Housing and Redevelopment Department staff will evaluate each eligible proposal/application for funds and assign a score based on a maximum 100 point scale using the following criteria: a. ORGANIZATIONAL ABILITY/CAPACITY Maximum of 25 Points i. Experience of organization in providing services to 5 p0jnts low/moderate income persons/households and in providing the proposed activity, ii. Capacity/ability of staff assigned to implement 5 Points proposed activity, ii. Organization's experience with the administration 5 Points of CDBG or other State or Federal funds. APPLICATION REVIEW PROCESS PAGE 3 iv. Level of ability demonstrated by organization to 10 Points provide services and to adhere to applicable local, State, or Federal regulations governing funding sources. FINANCIAL CAPACITY/STABILITY Maximum of 25 Points i. Leveraging of CDBG funds with outside resources 15 Points to finance proposed activity. II. Relatively stable financial position 10 Points IMPLEMENTATION OF ACTIVITY Maximum of 10 Points i. Demonstration of organization's readiness to 10 Points implement proposed activity BENEFITS/BENEFICIARIES Maximum of 40 Points i. Accessibility of activity for use by Carlsbad clients. 10 Points ii. Extent to which proposed activity benefits low 10 Points income persons/households (50% of median family income), iii. Extent to which proposed activity benefits low 10 Points income Carlsbad households iv. Extent to which proposed activity meets the needs 10 Points of low income residents 6. To facilitate the complete evaluation of eligible proposals/applications, applicants will be given the opportunity to participate in a 10 minute interview with the Funding Advisory Committee and staff. The public will also be given the opportunity to comment on the eligible proposals being considered for funding at a City Council meeting. The interview will provide the Advisory Committee and staff with an opportunity to obtain additional information regarding the organization and the proposed activity that may not have been provided, or was unclear in the application. Applicants should provide any documents that may assist the Advisory Committee and staff in evaluating the proposal/application prior to this interview. 7. Following the interview of each eligible proposal/application, Advisory Committee Members and staff will complete their evaluation of the proposal according to the criteria noted above. Committee Members will then submit their proposal scores to staff for averaging. Proposals must receive a minimum average score of 50 out of 100 points to remain eligible for funding. Staff will then rank and categorize the eligible proposals/applications into the following five classifications: a. Public services for the purpose of providing or maintaining affordable housing; b. Public services for the purpose of providing general social services; c. Public services for the purpose of providing specialized social services for children and adults; d. Proposals to create new affordable housing opportunities; and e. Other eligible projects not included in public service categories, such as facility improvements or property acquisitions. This information will then be presented to the Advisory Committee for further review to determine the level of funding to be recommended for each proposal. APPLICATION REVIEW PROCESS PAGE 4 8. It is the Advisory Committee's responsibility to make a recommendation on the level of funding to be allocated to the eligible activities according to the order the proposals/applications were ranked within each classification. The Advisory Committee shall work from the top of each list to the bottom, taking one proposal at a time on a rotation basis from each classification, and recommend a funding level for the proposal until all available funds have been allocated to eligible activities. This process will be used to make funding recommendations for public service, public facility/other, and affordable housing proposals. Recommended funding amounts will be distributed evenly among the three public service categories (housing, general social services, and specialized social services for children or adults). The minimum funding level for each recommended activity shall be $5,000, but shall not exceed the requested funding amount. EXAMPLE: The Advisory Committee shall take the highest ranked public service activity listed within "Affordable Housing" and make a funding recommendation for this activity. Then, the Committee will consider a funding recommendation for the second ranked proposal in that category, then the third, and so on, until no funds are available for that category. The Committee will then move on to the next public service category. This process will be repeated until funding recommendations have been developed for proposals in all of the categories. CDBG/HOME PROGRAM FUND ALLOCATION PROCESS PUBLIC SERVICE ACTIVITIES/PROJECTS TO' TO'pur Housing 1. 2. 3. TOTAL FAL FUNDS RECOMMENDED FAL FUNDS AVAILABLE General Social Services 1. 2. 3. TOTAL $ Social Services - Children & Adults 1. 2. 3. TOTAL $ MDS OVER/UNDER TOTAL AVAILABLES 9. The Advisory Committee's funding recommendations will be presented to the City Council for action during a public hearing. All applications submitted and the funding recommendations made by the Advisory Committee will be submitted to the City Council for consideration by the end of April of each year. 10. After accepting public comments on the proposals and recommendations, the City Council may accept the Committee's recommendations as submitted, or modify them as necessary to meet the needs of low/moderate income persons within the community. 11. Following City Council action, a Consolidated Funding Plan, including the list of selected activities and funding amounts for the CDBG/HOME Program, will be submitted to the U.S. Department of Housing and Urban Development for final CITY OF CARLSBAD COMMUNITY DEVELOPMENT BLOCK GRANT/HOME PROGRAM FUNDING PROPOSAL APPLICATION The following information must be completed by each person/agency/organization interested in being considered for CDBG/HOME funding. Please type or print clearly. Attach additional sheets or information as necessary. All information requested must be provided or the application will be considered incomplete and will not be further evaluated for funding consideration. The application must not exceed a total of fifteen (15) pages, including required Attachments A and B as listed in the Checklist of Required Documents. (Attachments C and D may also be required depending on the proposed project, but will not count towards the 15 page limit.) Ten copies of the completed application package, including appropriate attachments, must be submitted prior to 5:00 PM on January 8- 2009 to Frank Boensch, Housing and Redevelopment Department, 2965 Roosevelt Street, Suite B, Carlsbad, CA 92008. NOTE: Applicants may obtain a copy of this form in Microsoft Word format via internet email by contacting fboen@ci.carlsbad.ca.us. ADMINISTRATING AGENCY Name of Agency: Address: Federal Tax ID Number: PROPOSED PROGRAM/PROJECT Title of Program/Project: _ Location of Program/Project: Contact Person: Telephone No.: Email address: Requested Funding Amount: $ Brief Description of Program/Project (Describe the work to be performed, including the activities to be undertaken or the services to be provided, the goals and objectives of the program/project, etc.): Page 2 ORGANIZATIONAL ABILITY/CAPACITY A. This agency is: D Non-profit D For-profit D Local public agency D State public agency D Other (Please specify.) B. What is the purpose/mission of the agency? C. How long has this agency been in operation? Please include the date of incorporation? D. How long has this agency been providing the proposed program/project? E. Please submit an organizational chart for the agency as Attachment A. F. Please describe the agency's existing staff positions directly responsible for the proposed program/project and their qualifications and experience in implementing such a program/project. (Resumes may also be submitted as an optional Attachment B but not in lieu of a complete response.) G. Please indicate your agency's level of experience with the CDBG/HOME program. CDBG/HOME program: D No or little experience (up to 1 year of using CDBG/HOME funds) D Some experience (2 to 3 years of using CDBG/HOME funds) D Moderate experience (4 to 5 years of using CDBG/HOME funds) D Considerable experience (more than 5 years of using CDBG/HOME funds) Page3 H. If you have received federal funds, including CDBG/HOME funds, in previous years, have program violation findings ever been made against your agency/organization? D No D Yes If yes, please explain nature of finding(s) and how finding(s) has been addressed by your organization. II. FINANCIAL CAPACITY/STABILITY A. Please complete Page 6 itemizing revenues and expenses (sources and amounts) for the proposed program or project in which CDBG funds would be used. Indicate how the requested CDBG/HOME funds would relate to the overall proposed budget. B. Did you receive any of the following sources of funding from the City of Carlsbad within the last two years (2007-2008 and 2008-2009) for the proposed program/project? Sources of Funding No Yes CDBG 0 D Community Activities (General Fund monies) '-' ^ If yes, please indicate amount and status of previously awarded funds (fully expended, funds remaining, program/project discontinued). Amount Received Status CDBG/HOME funds Community Activities C. Did you receive any federal funds, including CDBG/HOME funding from other cities, last year (July 2008-June 2009)? D No D Yes (Please list funds below.) Program Source Amount Received $ $ $ D. Will additional CDBG/HOME funds be required in future years for the project? D No D Yes Page 4 III. BENEFITS & BENEFICIARIES A. How accessible or convenient is the proposed program/project to Carlsbad residents? (Please be specific such as direct services to client's home, transportation provided to and from facility, or relation to public transportation.) B. What is the approximate percentage of your clients that have annual family incomes in each of the following ranges: (Percentages should add to 100%; Please see the 2006-2007 Income Limits for the CDBG/HOME Program included in the Request for Proposals package.) % of clients are at 30 percent or below of the area median income % of clients are between 31 and 50 percent of the area median income % of clients are between 51 and 80 percent of the area median income % of clients are above 80 percent of the area median income C. Please describe how low and moderate income persons will benefit from the proposed program/project. Include the need or problem to be addressed in relation to Consolidated Plan housing and community development priorities, as well as the population to be served or the area to be benefited. (See Consolidated Plan Priorities) D. Please indicate the number of clients benefiting from the proposed activity and the percentage that are Carlsbad residents. Persons of which % are Carlsbad residents E. Does your agency focus its activities on populations with special needs? D No D Yes (Please specify) Please specify which special needs populations. (Homeless individuals/families, Persons with disabilities, Persons with substance abuse problems, Veterans, Farm workers & day laborers, Elderly, Children, etc.) PageS IV. IMPLEMENTATION OF ACTIVITY A. Please submit a schedule for implementation as Attachment C if this proposal is for construction, rehabilitation, property acquisition, other construction related activities, or a new public/community service program/project. Acquisition of property or construction related projects must also include an Attachment D for plans, scope of work, cost estimates, property listing, or other appropriate documents. The agency must ensure the expenditure of all CDBG/HOME funds awarded within the program year. I, the undersigned, do hereby attest that the above information is true and correct to the best of my knowledge. Signature Title Date Information below to be completed by Housing and Redevelopment Department staff. Date Received: Date Reviewed: Staff Person Completing Review: National Objective: Local Objective: Eligibility Determination: Page 6 2009-2010 PROJECT BUDGET Organization: Total Organization Budget $_ Project Name: CDBG/HOME Funds Requested: $ Total Program/Project Budget: $ Note: Indicate with an asterisk (*) funds that are volunteer time or in-kind contribution. 1. Sources of funding for project: a. Funding requested from the City $ b. Other federal funds (if any) C. State or local government funds d. Donations and contributions e. Fees or memberships f. In-kind contributions / Volunteer time g. Other funding h. TOTAL PROJECT FUNDING (project budget) $ 2. Uses of CDBG/HOME funds requested for the project: (1 .a.) a. Wages and salaries 5 b. Personnel benefits c. Materials and supplies d. Program expenses and evaluation e. Rent and utilities f. Insurance g. Mileage ( @ 44.50/mile) h. Incentives and Special Events i. Indirect costs j- k. I. TOTAL REQUESTED FUNDING (same as la.) 3. Percentage of project budget represented by CDBG/HOME request CITY OF CARLSBAD 2009-2010 COMMUNITY DEVELOPMENT BLOCK GRANT/HOME PROGRAM REQUEST FOR PROPOSALS I. Introduction Funding for the federal Community Development Block Grant (CDBG) Program is authorized under Title I of the Housing and Community Development Act. The program provides grants on a formula basis to entitled cities and counties to develop viable urban communities through the provision of decent housing, a suitable living environment and by expanding economic opportunities for lower income persons. Funding for the federal Home Investment Partnership (HOME) Program is authorized under Title II of the Cranston-Gonzales National Affordable Housing Act. The program provides grants on a formula basis to entitled cities, counties and city/county consortiums to create affordable housing for lower income households. The City of Carlsbad receives HOME funds as a member of the San Diego County HOME Consortium, a group consisting of the County of San Diego and various cities in the county formed for the purpose of obtaining federal HOME funds. II. Program Development The City of Carlsbad is eligible to receive CDBG funds on an annual basis. In order for Carlsbad to receive the grants, a list of community development objectives must be developed along with an outline of proposed projects. The City of Carlsbad must also certify that it has followed an approved Consolidated Plan for Housing and Community Development and that not less than 70% of the CDBG funds will be used for activities that benefit low and moderate income persons. Low and moderate income guidelines are based upon household size and a chart is attached for your reference. The City is eligible to receive HOME funds on an annual basis as a member of the San Diego County HOME Consortium. The City submits projects eligible for HOME funds to the Consortium for inclusion in the County's Consolidated Plan. The eligibility of households for HOME assistance varies with the nature of the funded activity. For rental housing and rental assistance, at least 90% of benefiting households must have incomes that are no more than 60% of the median family income for the area. In rental projects with five or more assisted units, at least 20% of the units must be occupied by families with incomes that do not exceed 50% of the area median income. The incomes of households receiving HOME assistance must not exceed 80% of the area median income. III. Request for Proposals The total amount of CDBG funds from the U.S. Department of Housing & Urban Development estimated to be available for Carlsbad in 2009-2010 is approximately $584,365. This figure includes an estimated $499,000 in new CDBG entitlement allocation, $83,865 available from program income, and $1,500 available for reallocation from prior year activities. Of the $584,365 total CDBG funds available, $99,800 will be used for the City's administration of the CDBG Program and $74,850 will be available for eligible public service activities. Approximately $204,800 will be available for public facilities, improvements and other eligible activities. Approximately $204,800 in CDBG funds will be available for selected projects that will provide affordable housing opportunities in Carlsbad. Approximately $260,000 will be available from the City's allocation of 2009-2010 HOME funds to assist in providing affordable housing opportunities for lower income households. The combination of 2009-2010 CDBG and HOME funds being made available for affordable housing totals approximately $464,800. Specifically, the $464,800 will be targeted for use in acquisition of property tor affordable housing purposes. Organizations are strongly discouraged from applying for funds unless they are ready to implement the activity proposed for funding. A matching funds requirement will be applied to CDBG funded public facilities/improvement activities, and documentation showing use of matching funds will be required prior to distribution of CDBG funds for activities under that category. CDBG funding for amounts of $100,000 or more may be made in the form of a deferred, no interest loan, to be forgiven in twenty years if the facility remains in use for purposes as stated in the application. To develop a 2009-2010 CDBG/HOME program which meets the needs of the lower income population, Carlsbad requests assistance from members of the community. Citizen participation is critical to the success of the Carlsbad CDBG/HOME program. Therefore, we are encouraging all qualified nonprofit organizations to consider the needs of lower income persons within Carlsbad and submit an application for a proposed project or service. The Proposal Review Process for the CDBG/HOME Program is attached for your information. Per federal regulations, all HOME funds must be used for affordable housing purposes and CDBG funds may be used for, but are not limited to: public service activities, acquisition of real property, relocation and demolition, rehabilitation of residential and nonresidential structures, construction of public facilities and improvements and conversion of schools for eligible purposes. The types of activities that generally are not eligible for CDBG funding include: buildings for the general conduct of government, political activities, income payments, construction of new housing and other facilities offering 24-hour care. NATIONAL OBJECTIVES The City of Carlsbad is committed to using CDBG funds to finance projects and services that provide direct benefit to lower income residents. Every project proposed for the CDBG program must address at least one of the three broad National Objectives for the program. The National Objectives are: 1. Provide direct benefit to lower income persons; 2. Aid in the prevention or elimination of slums or blight; and 3. Meet other community development needs having a particular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community where no other financial resources are available to meet such needs. LOCAL OBJECTIVES In addition to meeting the National Objectives, every project proposed for CDBG funding must meet at least one of the local Community Development Objectives, which are: 1. Affordable Housing: Provide direct benefit to lower income persons through the provision of additional affordable housing units in Carlsbad; Provide shelter or services to homeless or near homeless persons/families which result in an improved situation through employment, permanent housing, treatment of mental, or substance abuse problems, etc.; and, Provide direct assistance to lower income households to prevent or eliminate residential Building or Municipal Code violations and/or improve the quality of housing units in Carlsbad through residential (rental and/or owner occupied) rehabilitation programs. 2. SOCIAL SERVICES (GENERAL): Provide assistance to public service providers who meet the basic needs of lower income Carlsbad residents. Basic needs providers are defined as those that provide food, shelter, clothing, and in some cases, health care; Provide assistance to public service providers who offer counseling and self- improvement programs/activities for lower income Carlsbad residents; and, Provide assistance to public service providers who offer recreational and/or cultural programs/activities for lower income Carlsbad residents. 3. SOCIAL SERVICES (CHILDREN & ADULTS): Provide assistance to organizations which administer programs that directly benefit lower income children living in Carlsbad. The programs must provide one or more of the following activities: day care, after-school care, cultural enrichment, recreation, health care/immunization or self-improvement. The City may also give priority to single-parent assistance programs such as counseling services; and Provide assistance to organizations which administer programs that directly benefit lower income adults living in Carlsbad. The programs must provide ohe or more of the following activities for adults: employment services, job training, and educational programs. Programs designed for elderly adults only must provide one or more of the following activities: meals, homemaking or personal assistance services, financial assistance services, counseling, transportation, or shared housing or other housing related services. It is the intent of the City to only approve CDBG/HOME assisted projects that do not result in the displacement of lower income persons from their homes. Therefore, all persons submitting project proposals to the City should consider the displacement impact upon lower income households. IV. Submission of Request For Proposals All persons, organizations, agencies, etc. wishing to submit an application for funding consideration under the CDBG/HOME program must obtain a "Funding Proposal Application" from the City of Carlsbad Housing and Redevelopment Department. Interested persons may request a Funding Proposal Application by calling (760) 434-2818. Ten copies of each project proposal must be submitted to the attention of Frank Boensch prior to 5:00 p.m. on January 8, 2009 at the following address: CITY OF CARLSBAD HOUSING AND REDEVELOPMENT DEPARTMENT 2965 ROOSEVELT STREET, SUITE B CARLSBAD, CA 92010 IV. Technical Assistance/Questions or Comments City staff is available to provide technical assistance in preparing applications and to answer questions regarding the application review process. Please contact Frank Boensch at (760) 434- 2818 for information regarding technical assistance or if you have questions or comments on the CDBG/HOME Program. CITY OF CARLSBAD CDBG/HOME PROGRAM 2009-2010 FUNDING PLAN CITY OF CARLSBAD 2009-2010 COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM STATEMENT OF COMMUNITY DEVELOPMENT OBJECTIVES The City of Carlsbad Community Development Block Grant (CDBG) funds will be allocated to organizations, agencies, City Departments, or persons to implement programs or develop/improve public facilities which meet the following community development objectives: 1. AFFORDABLE HOUSING: • Provide direct benefit to lower income persons through the provision or retention of affordable housing units in Carlsbad; • Provide shelter or services to homeless or near homeless persons/families which result in an improved situation through employment, permanent or transitional housing, treatment of mental, or substance abuse problems, etc.; and, • Provide direct assistance to lower income households to prevent or eliminate residential Building or Municipal Code violations and/or improve the quality of housing units in Carlsbad through residential (rental and/or owner occupied) rehabilitation programs. 2. SOCIAL SERVICES (GENERAL): • Provide assistance to non-profit public service providers who meet the basic needs of lower income Carlsbad residents. Basic needs are defined as those which provide food, shelter, clothing and, in some cases, health care; • Provide assistance to non-profit public service providers who offer counseling and self- improvement programs/activities for lower income Carlsbad residents; and, • Provide assistance to non-profit public service providers who offer recreational and/or cultural programs/activities for lower income Carlsbad residents. 3. SOCIAL SERVICES (CHILDREN & ADULTS): • Provide assistance to organizations which administer programs that directly benefit lower income children living in Carlsbad. The programs must provide one or more of the following activities: day care, after-school care, cultural enrichment, recreation, health care/immunization or self-improvement. The City may also give priority to single-parent assistance programs such as counseling services; and • Provide assistance to organizations which administer programs that directly benefit low income adults living in Carlsbad. The programs must provide one or more of the following activities for adults: employment services, job training, and educational programs. Programs designed for elderly adults only must provide one or more of the following activities: meals, homemaking or personal assistance services, financial assistance services, counseling, transportation, or shared housing or other housing related services. 2 of 5 CITY OF CARLSBAD 2009-2010 COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM SUMMARY OF ESTIMATED FUNDS AVAILABLE FOR 2009-2010 PROGRAM YEAR Source of Funds Amount($) New Entitlement Grant 499,000 Program Income 83,865 Reallocation of Prior Year Funds 1,500 TOTAL 584,365 Funds Available by Activity Amount ($) Public Service 74,850 Affordable Housing 204,857 Public Facilities, Improvements/Other 204,857 Program Administration/Fair Housing 99,800 Total Available Funds 584,364 3 of 5 2009-2010 HOME INVESTMENT PARTNERSHIP PROGRAM STRATEGY The City of Carlsbad, as a member of the San Diego Urban County HOME Consortium, may allocate its HOME Investment Partnership funds to implement the following activities directly, through local housing authorities, or for-profit or non-profit organizations: 1. Property Acquisition/Housing Construction HOME funds may be used for property acquisition and all other eligible costs of providing new affordable housing for lower-income persons and special needs groups. 2. Housing Acquisition/Rehabilitation HOME funds may be used for acquisition of existing housing units with or without rehabilitation for lower-income persons and special needs groups. 3. Housing Rehabilitation HOME funds may be used for housing rehabilitation costs incurred separately or in connection with the acquisition of existing housing for lower-income persons and special needs groups. 4. Rental Assistance HOME funds may be used for tenant based rental assistance, related residential security deposit assistance programs, and other eligible related costs. 5. Home Buyer Assistance HOME funds may be used for home buyer assistance programs for lower income persons. Such programs may include, but are not limited to, downpayment and closing cost assistance, direct loan to the home buyer, interest subsidy to the lender, or "gap" financing. 6. Administration/Planning A portion of HOME funding may be used for eligible HOME administration and planning costs, including direct administrative and overhead costs, public information, fair housing, and program development costs. Funding Process The City's portion of HOME funds will be awarded to eligible housing activities implemented by the City or by for profit or non-profit organizations on behalf of the City. Staff of the Housing and Redevelopment Department shall evaluate and determine those eligible housing activities to be considered for funding under the HOME Program based upon the housing need priorities established in the City's General Plan Housing Element and the Consolidated Plan. Staff will present the recommendations for project funding to the City Council for consideration and final approval. Leverage 4 of 5 In so far as possible, HOME funds will be leveraged with other public and private funding sources to enhance program productivity. Area of Activity HOME funds may be used for housing activities implemented within the City of Carlsbad. CITY OF CARLSBAD HOME INVESTMENT PARTNERSHIP PROGRAM SUMMARY OF FUNDS AVAILABLE FOR 2009-2010 PROGRAM YEAR 2009-2010 HOME Funding Allocation for Carlsbad $260,000 5 of 5 Page 1 of 3 Council Internet Mailbox - RE: Information on the TERI Inc Grant From: "Jim Benson" <jbenson@almargroup.com> To: "Debbie Fountain" <Dfoun@ci.carlsbad.ca.us> Date: 01/08/2009 9:18 PM Subject: RE: Information on the TERI Inc Grant CC: "Council Internet Mailbox" <Council@ci.carlsbad.ca.us>, "Manager Internet Email" <Manager@ci.carlsbad.ca.us>, "Robin Nuschy" <Rnusc@ci.carlsbad.ca.us> Debbie, Also, I would like to know who else applied for this specific grant and if they were approved or not. If they were not approved, I'd like to know why. If they were approved, how much money did they receive? Thank you, Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL Real Relationships. Real Success. 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: jbej^oniScbcwgjIdv^dacQrn | Web: ONCOR INTERNATIONAL From: Debbie Fountain [mailto:Dfoun@ci.carlsbad.ca.us] Sent: Thursday, January 08, 2009 5:38 PM To: Jim Benson Cc: Council Internet Mailbox; Manager Internet Email; Robin Nuschy Subject: RE: Information on the TERI Inc Grant OK. I will have someone work on that tomorrow and get the copies to you early next week. Hope that is OK. >» "Jim Benson" <jbenson@almargroup.com> 1/8/2009 5:35 PM >» Debbie, I appreciate your quick response. I would also like a copy of the original application as well as any and all correspondence between the City and TERI prior to and after the original application. I would also like any and all correspondence between the City and TERI prior to, during and after the approval process. Thanks, Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL Real Relationships. Real Success. 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: ibenson@cbcworldwide.com I Web: www.cbcworldwide.com file://C:\Documents and SettinPs\Klinh\T,oc,al Settinas\Temn\YPamwi<MA4Q^fin»8rTW_ con # Ro4 •£»«, bo*Wi to -kp » Pagelof2 Council Internet Mailbox - RE: Letter to Bressi Residents from City Attorney Ron Ball From: "Jim Benson" <jbenson@almargroup.com> To: "Debbie Fountain" <Dfoun@ci.carlsbad.ca.us> Date: 01/13/2009 5:09 PM Subject: RE: Letter to Bressi Residents from City Attorney Ron Ball CC: "Council Internet Mailbox" <Council@ci.carlsbad.ca.us>, "Manager Internet Email" <Manager@ci.carlsbad.ca.us>, "Robin Nuschy" <Rnusc@ci.carlsbad.ca.us> Debbie, I'm sorry to hear that is all the City Council is willing to do. I'm also sorry to hear the City Council made this decision prior to the January 27th City Council meeting in which this specific item was placed on the agenda. At this point it sounds like the City Council meeting will be a waste of time for the many 'concerned residents of Carlsbad. Per your e-mail below, Mrs. Kulchin wanted to ensure nothing had been missed from a legal perspective as seemed to be indicated by some of the homeowners. It sounds like she wanted to make sure the Council was not legally liable. Now that she has these assurances, she can just drop the whole issue and go on her way. The homeowners were not concerned with whether or not the City had missed anything from a legal perspective. The homeowners / taxpayers want to know why the City of Carlsbad wrote TERI a blank check with no provisions or safeguards as to how the money was to spent. It was careless and irresponsible on the City Councils part to do absolutely no due diligence on where this house would be located and how the money would be spent prior to rubber stamping their approval. Also, thank you for throwing in you unsolicited opinion that requiring TERI to sell their house would not be the right thing to do. Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL ' Real Relationships. Real Success. 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: jbenson@cbcworldwide.com | Web: www.cbcworldwide.com ONCOR INTERNATIONAL From: Debbie Fountain [mailto:Dfoun@ci.carlsbad.ca.us] Sent: Tuesday, January 13, 2009 4:31 PM To: Jim Benson Subject: Re: Letter to Bressi Residents from City Attorney Ron Ball Jim. The letter represents the legal opinion of the City Attorney and, as noted within the letter, it was shared with you at the request of the Mayor. At the meeting on January 5th, Mayor Pro Tern Kulchin indicated that the City Attorney and his staff would be asked to look at the matter one more time and determine if we had any other options from a legal standpoint. Mrs. Kulchin's intent was to confirm that nothing had been missed from a legal perspective as seemed to be indicated by some of the homeowners who stated they were attorneys. The City Attorney has done his research and determined that it is not within the legal jurisdiction of the City Council to permit or deny the location selected by TERI for their group home (as was stated at the meeting). All the laws noted in the correspondence are the reason for his opinion. As a result, there are no legal or other options for the Council to pursue. There is no other letter to be sent to you on the Council's legal jurisdiction or other legal options in this matter. No action file://C:\Documents and Settings\Klinh\T,nr.a1 Settinas\Tprrm\YParnwkp\4Q6rr APnnw. 09/1 Page 2 of2 is being considered by the City which would require TERI to sell the home and find a new location. It is not legal and would not be the right thing to do. I am preparing another letter to send to you in response to your e-mail inquiries for additional information and requested documents on the federal funding for the acquisition of the home. That correspondence should be sent to you within the next day or so. At the meeting on January 5th, you indicated to me that you would be the contact person for the interested homeowners and share the information returned to you. We had no discussion about the Council responding, verbally or in writing, to every homeowner individually. My understanding was that you would forward the information to them. If, however, you have changed your mind and would like this information to be forwarded directly to the homeowners rather than be distributed through you, please provide me with a list of names and addresses for those in attendance at the January 5th meeting and I will do so. Thank you. n" <jbenson@almargroup.com> 1/13/2009 3:20 PM >» Debbie, I am forwarding the attached letter sent to me today, in which I believe you were copied, by City Attorney Ron Hall. As I'm sure you will agree, the entire letter was based on references of different codes and State laws. Whereas I appreciate all of the effort his assistant put into researching this topic, I am hopeful that this is not the letter or information you promised you would send me in your e-mail dated January 7 where you said "I shared with her (Mimi Manzano) that my understanding was that the \/ residents accepted the Council's offer to have our attorneys review the issue and determine the City's options at this point. My understanding is that I am to report back to you when the attorney completed his review and we knew what action we might take. We did not have a specific time frame but agreed we would try to do that as quickly as possible". Please reply back and assure me that another letter will be forthcoming. Please don't tell me that the City Council reviewed the attached letter and approved it to go out without including the City's options as promised. I don't want to be the person informing the Bressi residents that there is nothing the City can do to rectify the blank check written to TERI Inc. and, oh, by the way Bressi residents, the City Council has decided not to respond verbally or in writing to the 150 Bressi residents that believed this issue was important enough to leave their families for a night to meet with the City Council and share our fears and concerns. I look forward to your response. Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL Real Relationships. Real Success, 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: jbenson@cbcworldwide.com | Web: www.cbcworldwide.com ONCOR INTERNATIONAL file://C:\Documents and Settines\Klinb\Local $ettincrs\Temn\YParnwkpUQ£rr Arnrvw/. m/i n/onno RONALD R. BALL PAULG. EDMONSON CITY ATTORNEY CITY OF ASSISTANT CITY ATTORNEY JANEMOBALDI f API QRAll RONALD KEMP ASSISTANT CITY ATTORNEY VM/^IVL. <J D/~\L/ DEPUTY CITY ATTORNEY 1200 Carlsbad Village Drive Carlsbad, CA 92008-1949 T 760-434-2891 F 760-434-8367 January 13, 2009 Jim Benson sent via e-mail @ Bressi Ranch Residents jbenson@almargroup.com Carlsbad CA, 92009 Re: Your Request to Address the City Council Regarding the TERI Inc. Home at 6205 Alverton Drive, Carlsbad Dear Mr. Benson: The Mayor has asked that I advise the Council and you of the laws governing the location and operation of a group home of six or fewer mentally or physically disabled persons which has been licensed by the State of California and provides care on a 24 hour basis. I believe answers to some of your questions have previously been provided by the Housing and Redevelopment Director in the form of the "Frequently Asked Questions and Answers" and the "Fair Housing Law" copies of both of which are enclosed herein. The laws governing the location, permitting and operation of such a home are contained in three (3) statutory schemes that provide state protection for this kind of use and preempt local legislative body from interfering with their licensed operations and peaceful existence. The first, the Lanterman-Petris-Short Act (California Welfare & Institutions Code § 5000 et seq.) establishes the policy of the State of California "that mentally and physically handicapped persons are entitled to live in normal residential surroundings and should not be excluded therefrom because of their disability" (Cal. Welf. & Inst. Code §5115). In furtherance of this policy, the legislature has declared that: "a state-authorized, certified, or licensed family care home, foster home, or group home serving six or fewer mentally disordered or otherwise handicapped persons or dependent and neglected children, shall be considered a residential use of property for the purposes of zoning if such homes provide care on a 24- hour-a-day basis. Such homes shall be a permitted use in all residential zones, www.carlsbadca.gov including, but not limited to, residential zones for single-family dwellings." (Cal. Welf. & Inst. Code §5116.) rf The second, the legislature has stated in the Community Care Facilities Act (California Health & Safety Code §1500 et seq.) that: "... it is the policy of this state that each county and city shall permit and encourage the development of sufficient numbers and types of residential care facilities as are commensurate with local need. The provisions of this article shall apply equally to any chartered city..." (Cal. Health & Safety §1566) In Cal. Health & Safety §1566.3 the legislature has further declared: "(a) Whether or not unrelated persons are living together, a residential facility that serves six or fewer persons shall be considered a residential use of property for the purposes of this article. In addition, the residents and operators of such a facility shall be considered a family for the purposes of any law or zoning ordinance which relates to the residential use of property pursuant to this article. (b) For the purpose of all local ordinances, a residential facility that serves six or fewer persons shall not be included within the definition of a boarding house, rooming house, institution or home for the care of minors, the aged, or the mentally infirm, foster care home, guest home, rest home, sanitarium, mental hygiene home, or other similar term which implies that the residential facility is a business run for profit or differs in any other way from a family dwelling. (e) No conditional use permit, zoning variance, or other zoning clearance shall be required of a residential facility which serves six or fewer persons which is not required of a family dwelling of the same type in the same zone "(emphasis added) Citizens who disagree with this state-wide policy can be referred to their state legislators. Third, State and Federal anti-discrimination in housing laws prohibit housing discrimination on the basis of disability (see the California Fair Employment & Housing Act (Cal. Govt. Code §12900 et seq.) and the Federal Fair Housing Act (42 U.S.C. 3601).) Such prohibitions are broadly interpreted by both State and Federal Courts and have been used to prevent municipalities from enforcing zoning or other restrictions which would preclude group homes for the disabled in certain neighborhoods. Both State and Federal, policy is to encourage the integration of people with disabilities in residential neighborhoods. "In case after case, courts have concluded that the [Fair Housing Act] has been violated where municipalities have attempted to prevent or restrict persons with disabilities from living in the single family-zoned homes of their choice, even when the number of residents exceeds the number of unrelated people permitted to live together under the applicable zoning ordinances." (Dr. Gertrude A. Barber Center v. Peters Township (2003) 273 F.Supp. 2d 643, 651.) The TERI Group Home will need to be licensed by the California Department of Social Services. The City of Carlsbad has no involvement in permitting or denying the license. Citizens with questions regarding the licensing requirements or wishing to make a complaint about licensing violations can be referred to the California Department of Social Services' San Diego office at (619) 767-2300. As you can see from the above, the State has occupied the field for providing care on a 24 hour basis to physically or mentally disabled persons and your questions or concerns are more properly addressed to it. Should you have any questions regarding the above, please do not hesitate to contact me. yours, \ &vz-QJZ_^. RONALD R. BALL City Attorney rn/enclosure c: Mayor and Council Members City Manager Planning Director Housing and Redevelopment Director FAIR HOUSING LAW The California Legislature has declared that discrimination in housing is against the public policy of the State of California. Moreover, the Legislature has recognized that the light to seek, obtain, and hold housing without discrimination on any of the bases specified in the Fair Employment and Housing Act or on any other basis prohibited by the Unruh Civil Rights Act is a civil right. The Fair Employment and Housing Act (FEHA), Government Code section 12900 et seq., specifically prohibits housing discrimination on the basis of race, color, religion, sex, sexual orientation, marital status, national origin, ancestry, familial status, disability, or source of income. The Act prohibits local governments from making housing opportunities unavailable to people with disabilities through discriminatory land use and zoning rules, policies, practices and procedures. The legislative history of the Act recognizes that zoning provisions have discriminated against people with disabilities by limiting opportunities to live in the community in congregate and group living arrangements. The Act explicitly prohibits discriminatory "public or private land use practices, decisions and authorizations" including, but not limited to, "zoning laws, denials of permits, and other (land use) actions.. .that make housing opportunities unavailable" to people with disabilities. The Unruh Civil Rights Act, Civil Code section 51 (hereafter the Unruh Act or the Act) prohibits discrimination in "all business establishments of every kind whatsoever."- This provision has been interpreted to include businesses and persons engaged in the sale or rental of housing accommodations. While the Act specifically prohibits only discrimination on the basis of race, color, religion, sex, national origin, ancestry, or disability, its language, unlike the FEHA's, has been judicially and statutorily construed to apply to arbitrary discrimination based on personal traits, beliefs, or characteristics similar to those specifically listed. The Act, for example, has been held to prohibit discrimination against families with children and against persons based upon their sexual orientation or their age.- Accordingly, the Act does not apply only to those bases which are specifically listed, but may also apply to other, unlisted but similar bases, as well. hi addition, the Unruh Act, like the FEHA, prohibits discrimination against persons who are perceived to be a member of a protected class or who associate with a member of, or with a person perceived to be a member of, a protected class.- The FEHA also prohibits harassment of persons applying for or occupying housing accommodations on any of the bases specified in the Act. The FEHA and the Unruh Civil Rights Act can be enforced against any owner, lessor, sublessor, assignor, managing agent, real estate broker, salesperson, or any person having any legal or equitable right of ownership or possession or the right to rent a housing accommodation. The provisions of the FEHA are generally applicable to any real property that is occupied or intended to be occupied as a home, residence, or sleeping place by one or more families. Only two categories of housing are expressly exempted. First, the FEHA does not apply to renting a portion of a single-family, owner-occupied house to one person. Second, religious organizations which own or operate housing accommodations for non-commercial purposes, either directly or through a related non-profit institution or organization, may give a preference to persons of the same religion in the sale, rental, or occupancy of such accommodations. The Unruh Act covers any form of housing which can be termed a "business establishment." This term has been liberally construed by the courts to include virtually every type of housing accommodation. For example, the Act has been held to apply to operators of motels and hotels; real estate brokers and agents and others engaged in the sale or rental of real property; owners of triplexes, duplexes, non-owner occupied single-family dwellings, and publicly-assisted housing projects; operators of mobile home parks; and condominium homeowners' associations. The following is a partial listing of housing practices prohibited by the FEHA and the Unruh Act. It is unlawful: o to make any inquiry concerning the race, color, religion, sex, national origin, ancestry, or other protected characteristic of the person seeking to rent, purchase, or lease any housing accommodation; o to place an advertisement regarding the rental or sale of any housing accommodation which indicates any preference or limitation based upon race, color, religion, sex, national origin, ancestry, or any other characteristic protected by the FEHA or the Unruh Act; o to discriminate against any loan applicant for a loan to purchase or construct housing on a prohibited basis; o to harass, evict, or otherwise discriminate against any person who has filed a complaint with the DFEH or who has testified or assisted in any action brought pursuant to the FEHA; o to aid, abet, incite, compel, or coerce the doing of any of the foregoing illegal practices; o to refuse to sell, rent, or lease a housing accommodation on any prohibited basis; o to refuse to negotiate for the sale, rental, or lease of a housing accommodation on any prohibited basis; o to misrepresent tSe availability of a housing accommodation because the prospective buyer or lessee is a member of a class protected by either the FEHA or Unruh Act; o to provide inferior terms, conditions, privileges, facilities, or services in connection with the sale or lease of a housing accommodation because the buyer or lessee is a member of any class protected by the Unruh Act or the FEHA; o to cancel or terminate a sale or rental agreement because a person is a member of a class protected by either the FEHA or Unruh Act; o to provide segregated housing accommodations. o to harass someone in connection with housing accommodations. Remedies available from the Fair Employment and Housing Commission (FEHC) in administrative actions for housing discrimination include; orders requiring the sale or rental of the housing accommodation if it is still available; payment of actual damages; and payment of a civil penalty of up to $50,000.- Remedies available in private actions brought to enforce your rights depend upon whether your claim is brought pursuant to the Unruh Act or the FEHA. Remedies available in private Unruh Act suits include actual damages, a penalty of up to three times the amount of actual damages, injunctive relief, and attorney's fees.- Remedies available in private FEHA actions, or in a civil trial elected in lieu of an administrative hearing before the FEHC, include actual, compensatory, and punitive damages, injunctive relief, and attorney's fees if you are represented by private counsel rather than by the DFEH. Miscellaneous State Statutes Prohibiting Discrimination in Housing These additional state statutory references also concern unlawful housing discrimination. 1. Civil Code sections 51.2 through 51.4, and Sl.lOthrough 51.12 recognize the need for specially designed accessible housing for senior citizens, and establish age limitations and other qualifications for permissible senior citizen housing developments. 2. Civil Code section 53 prohibits discriminatory provisions in written instruments which attempt to forbid or restrict the conveyance, encumbrance, leasing, or mortgaging of real property to any person on the basis of sex, race, color, religion, ancestry, national origin, or disability or which attempt to limit the use or occupation of real property by any person on such bases. 3. Civil Code section 51.9 prohibits, among other things, the sexual harassment of a tenant by a landlord or property manager. 4. Civil Code section 54.1 subdivisions (a)(6)(A), (B) and (C)(i) declare that blind persons, other visually impaired persons, deaf persons, and other disabled persons are entitled to full and egual access to all housing accommodations offered for rent, lease, or compensation, for both themselves and any guide, signal, or service dog whose services they use. 5. Civil Code sections 782 and 782.5 void discriminatory provisions in deeds and other written instruments relating to title to real property which purport to restrict the right of any person to sell, buy, lease, rent, use, or occupy such property on the basis of race, color, nationality, or ethnicity. 6. Government Code section 12956.1 provides that a county recorder, title insurance company, escrow company, real estate broker, real estate agent, or association that provides a copy of a real estate document to any person shall place a cover page or stamp on the first page of the document stating, in specified language, in at least 14-point boldface type, that any unlawful restrictive covenant contained in the document is void and may be removed, and that lawful restrictions on age of occupants in senior housing shall not be construed as restrictions based on familial status. 7. Government Code section 12956.1, subdivision (c), provides that any person who holds an ownership interest in property that he or she believes is the subject of a restrictive covenant may file an application with the DFEH requesting a determination of whether the restrictive covenant violates the fair housing laws and is void. The applicant may strike the void restrictive covenant identified by the department. 8. Health and Safety Code section 33050 is a legislative declaration of policy against discrimination in the undertaking of community redevelopment projects based on race, color, religion, sex, marital status, national origin, or ancestry. 9. Health and Safety Code section 33769 requires that any residence constructed with funds obtained through, or with the assistance of, a redevelopment agency be made available without regard to race, color, religion, national origin, or ancestry. 10. Health and Safety Code section 37923 requires that residences acquired, constructed, or rehabilitated with community development funds be open to all without discrimination on the basis of race, color, religion, national origin, or ancestry. Federal Laws The Federal Fair Housing Act and 42 U.S.C. § 1982 Title VIII of the Civil Rights Act of 1968, the Federal Fair Housing Act (FFHA) (42 U.S.C. § 3601 et seq.), also reaffirms and protects your rights to fair housing. The FFHA prohibits discrimination in the selling or rental of housing accommodations on the basis of race, color, religion, sex, familial status (families with children), handicap, or national origin.- Additionally, the FFHA prohibits discrimination by financial institutions in the making of commercial real estate loans, and prohibits anyone from discriminating in the provision of real estate brokerage or appraisal services. The authority and responsibility for administering the provisions of the FFHA lies with the United States Secretary of Housing and Urban Development. For more information concerning your rights and remedies under the FFHA, you should contact your local office of the Department of Housing and Urban Development (HUD). You should note that if you believe that you have a claim under the FFHA, you must file a written complaint within one year after the alleged discriminatory act occurred or terminated, if you would like HUD's assistance in resolving the claim. HUD will investigate your complaint, attempt to resolve it by conciliation, and, if necessary, proceed to have the matter heard either in court or in an administrative hearing. After an administrative hearing, actual damages and injunctive relief may be awarded as well as a civil penalty of up to $50,000. Alternatively, you may also file an action directly in court, without first filing with HUD. Any such court action must be filed within two years after the alleged discriminatory act. If you prevail, you may recover actual and punitive damages, injunctive relief, and reasonable attorney's fees. In addition to the FFHA, 42 U.S.C. § 1982 also prohibits discrimination in the area of housing. Section 1982 states: "All citizens of the United States shall have the same right, in every state and territory, as is enjoyed by white citizens thereof to inherit, purchase, lease, sell, hold, and convey real and personal property." Thus, section 1982 bars all racial discrimination, private as well as public, in the sale or rental of property. Although section 1982 and the FFHA share the same goals, the two federal remedies do differ in a few significant respects. First, section 1982 only prohibits discrimination based upon color or race, whereas the FFHA applies more broadly. Second, section 1982 is enforceable only through private action, while the FFHA establishes an administrative scheme. Lastly, while section 1982 is generally limited to discrimination in the sale or rental of property, the FFHA extends to, other related areas, such as discrimination in the provision of brokerage services. A section 1982 action, like a 42 U.S.C. § 1981 claim, can be brought in either state or federal court, and you do not need to file an FFHA claim before you file a section 1982 court action. Local Jurisdiction Responsibilities The City of Carlsbad must comply with all federal and state fair housing laws. It may not take any action which results in intentional discrimination or has a discriminatory effect. Elected officials that intentionally discriminate or adopt a discriminatory practice will face liability under fair housing laws. The City also has the affirmative duty under both federal and state housing law to provide reasonable accommodation in land use and zoning rules, policies, practices and procedures where it may be necessary to provide individuals with disabilities equal opportunity in housing. The City may not implement practices such as permitting, noticing and public hearing processes which could stigmatize prospective residents with disabilities. This is the reason that the City does not require a permit or notice of group homes for disabled adults/youths. It would be discriminatory to do so. TERI Group Home Bressi Ranch Frequently Asked Questions and Answers * The City of Carlsbad has been contacted by some residents with questions about the recent purchase of a Bressi Ranch home by the Training Education and Research Institute (TERI) to serve six developmentally disabled adults. To help ensure the community has accurate information, the City has prepared this Questions &Answers document. Who is TERI and what do they do? TERI, Inc. Phone: 760-721-1706 251 Airport Road Fax:760-721-9872 Oceanside, CA 92058 E-mail: info@teriinc.org The Training Education and Research Institute (or TERI) is a nonprofit organization that provides services to individuals with developmental and learning disabilities. TERI is a well respected organization that was established and has been operating since 1980. The organization has enjoyed substantial support throughout North County, and numerous families from Carlsbad have utilized their services for many years. TERI has owned and operated a single family group home in the La Costa area of Carlsbad for 27 years. The organization currently administers residential programs in 10 group homes and operates a day program for 180 adults with developmental disabilities. Residents in TERI's programs receive "active treatment" in both their living environment and day programs. Active treatment supports the client in the activities of daily living through teaching, modeling and assisting. Clients attend a day program Monday through Friday from 9:00am to 3:00pm with TERI providing transportation to and from this activity. What funding was provided by the City and why? TERI applied for a Community Development Block Grant or "CDBG" loan from the City of Carlsbad in February 2008 to help them acquire another home in Carlsbad that could be used to house up to six clients with autism and developmental disabilities. Within the application, TERI noted that persons with developmental disabilities have a need to live as normally as possible, and residential programs of no more than six individuals are particularly effective in building a sense of family and community. At the time of application, TERI had not yet selected a home to purchase. It was not possible to identify a property at the time due to the substantial processing time required before TERI would have received confirmation of project funding. TERI, however, did provide information on the type of home that would be suitable for the noted residence. The ideal property was a single family home with 4 to 5 bedrooms and approximately 3 bathrooms. The selection and purchase of the specific home was made after the funding was awarded by the City, which is acceptable under the CDBG program. CDBG rands are provided by the federal government to assist communities in meeting the needs of low income households of all types, including those with special needs such as the disabled. The application process for these funds begins in November/December of each year for the following program year. For example, funding requested in December 2008 will not be available to the applicant until approximately August/September of 2009. The application process is a lengthy public process that includes review by a Citizens Advisory Committee, several public hearings before the City Council, and general public notices on intended use(s) of the funds. In accepting the funds, the City agrees that it will not engage in any discriminatory activity and will make every effort to advertise availability of the funds and encourage organizations to apply for funding to meet the diverse needs of the low income populations within the community. TERI is an eligible applicant that submitted a project for funding that meets both national and local objectives for the CDBG program. The CDBG Advisory Committee, which is made up of a resident from each quadrant of the City, a Housing Commissioner, Senior Commissioner and Planning Commissioner, recommended and City Council approved a loan of $795,000 for TERI to acquire a home in Carlsbad. TERI was required to demonstrate that it is using matching funds of one dollar for every two dollars of City CDBG funds. TERI also received approval of a loan from the federal Department of Housing and Urban Development or "HUD" for $582,900 to assist in the purchase and improvements needed to utilize and license the property as a group home with the State of California. Is a Group Home allowed in a residential neighborhood? Is a notice required to the neighbors? State law and the City of Carlsbad's Zoning Ordinance both allow residential care facilities (or group homes) serving six or fewer persons in a residential zone. For the purposes of determining the appropriateness of the group home occupying a single family home, "family" is defined in the Carlsbad Zoning Ordinance (Section 21.04.145) as "a reasonable number of persons who constitute a bona fide single housekeeping unit." The definition includes residents and operators of a residential care facility serving six or fewer persons. Section 21.04.300 of the Carlsbad Zoning Code defines "residential care facility" as "a state authorized, certified or licensed family care home, foster home or group home serving mentally disordered or otherwise handicapped persons, or dependent and neglected children where care is provided on a twenty-four hour a day basis." This use (group home) is permitted without any discretionary permits issued by the City. State law prohibits the City from requiring a permit for such a use as it would be deemed discrimination against disabled individuals. Therefore, there is no public process for approval and/or noticing to neighbors. The use is permitted by right. Because it is comparable to any type of family moving into a single family home, noticing of this specific family type (disabled) would be discriminatory. How was the location selected? Why did the City allow the purchase in Bressi Ranch? After many months of searching for a suitable home, TERI decided to purchase the property at 6205 Alverton Drive (within Bressi Ranch) for approximately $1 million. The price paid was based on a fair market appraisal of the property as of October 7, 2008. Escrow closed on the purchase in late November, 2008. The Group home is currently being retrofitted to meet state requirements and is not yet occupied. Under the Federal Fair Housing Act, it is against the law to direct homebuyers to certain neighborhoods only, make housing unavailable, or deny a dwelling based on race/color, national origin, religion, gender, familial status, or disability. It is also against the law to harass, coerce, intimidate, or interfere with anyone exercising or assisting someone else with their fair housing rights. The City and other parties (including real estate agents) to this transaction would have engaged in a discriminatory practice if it had directed TERI to an alternate neighborhood within Carlsbad and/or another City. Is a $1 million home to serve six people an appropriate use of taxpayer money? TERI operates homes in communities throughout North County. TERI's goal is to house its clients in the communities where their families live or where they have roots. In Carlsbad, it is fairly expensive to provide affordable housing for low income households, especially the disabled. Based on Carlsbad's experience in providing low income affordable housing, it currently costs a minimum of approximately $275,000 to produce a single rental housing unit. If we were to assume that each of these six adults were to be/housed separately, the cost is estimated at $1,650,000. The purchase of a $1 million single, large group home is reasonable and appropriate in comparison to the construction of individual units. What laws and government agencies oversee group homes like this? The California Department of Social Services licenses care facilities for persons who cannot live alone but who do not need extensive medical services. The agency ensures community care facilities operate according to applicable laws and regulations (California Health & Safety Code and Title 22 of the California Code of Regulations). Compliance is maintained through unannounced facility inspections, complaint investigations, issuing deficiency notices, consultations, education and technical support. More information is available on the department's Web site, http://www.ccld.ca.gov. If you have questions about licensing and monitoring of group homes, you may contact the San Diego Residential Office for the California Department of Social Services at (619) 767-2300. Ask for the Group Home Duty Worker. Page 1 of 1 Council Internet Mailbox - Activity at the TERI Inc. House in Bressi Ranch From: "Jim Benson" <jbenson@almargroup.com> To: "Debbie Fountain" <Dfoun@ci.carlsbad.ca.us> Date: 01/13/2009 4:14 PM Subject: Activity at the TERI Inc. House in Bressi Ranch CC: "Council Internet Mailbox" <Council@ci.carlsbad.ca.us>, "Manager Internet Email" <Manager@ci.carlsbad.ca.us>, "Robin Nuschy" <Rnusc@ci.carlsbad.ca.us> Debbie, I thought I should bring to your attention all of the activity going on at the TERI Inc. house at 6205 Alverton. As of today, TERI had two 'Door-to-Door' storage units delivered to the house. There have also been many work vehicles and workers to the house. It gives me the impression that they are now moving in. I believe it was Bill Mara, TERI Inc's Chief Operating Officer, that informed our group that they would not be occupying the house for five months. It seems very coincidental that one week after the Bressi Ranch /City Council meeting at the Bressi Ranch clubhouse TERI seems to be moving in. This wouldn't be so it is even more difficult for the City to try and change the course of action, should the Council decide to go that route. This seems to be another way for TERI to sneak in the back door, the same way this entire process has happened. Jim Benson Senior Vice President - Partner COLDWELL BANKER COMMERCIAL Real Relationships. Real Success. 5800 Armada Drive, Suite 101, Carlsbad, CA 92008 Direct: 760.517.5832 | Fax: 760.517.5880 | Mobile: 760.822.7428 Email: jbenson@cbcworldwide.com | Web: www.cbcworldwide.com ONCOR INTERNATIONAL file://C:\Documents and SettinRs\Klinb\Local Settines\TemD\XPgn)wise\496CRDF9GW- 07/10/700Q From: <quinby2@att.net> To: <Council@[205.142.109.13]> Date: 01/06/2009 1:16 PM Subject: CITY OF CARLSBAD | CONTACT US A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: Januarys, 2009 TO: Carlsbad City Council FROM: David L. & Linda J. Quinby, Carlsbad/Bressi Ranch Residents SUBJECT: Group home in Bressi Ranch We live in Bressi Ranch, having purchased a home here and moved to Carlsbad just 6 months ago. We are now appalled to learn that the City of Carlsbad has provided $800,000 (in addition to nearly $600,000 from the federal government) to TERI Inc. to establish a group home down the street from us to serve up to six developmental^ disabled men. There are a number of issues with this plan. 1. Wasteful use of taxpayer money: Spending over $1 million of taxpayer money for a group home in an upscale neighborhood is an outrageous use of funds by the city and by a non-profit, charitable organization. TERI could have easily bought two homes in less expensive neighborhoods and served twice as many disabled individuals. Being ofairo to handicapped people who require government financial assistance should not include using government money to buy into an expensive neighborhood far beyond the financial ability of the vast majority of Americans. Although the City says that TERI has a right to purchase a home wherever they wish, we feel that the city has the right and responsibility to conduct cost-benefit and impact analyses before providing the funds. Taxpayers are rightfully angry when they see their tax dollars spent in this manner. 2. Inappropriate site: Bressi Ranch was designed as a high-density, pedestrian- and family-friendly neighborhood with strict CC&Rs. The area of Bressi Ranch where the home is being placed includes the densest of the various single-family-home neighborhoods. Children commonly play on the sidewalks and in the streets. There is an expectation of safety. Given the nature of the neighborhood, the proposed site is inappropriate for several reasons: a. Safety of children & others: TERI serves a broad range of clients who can be a danger to themselves and others, and therefore proposes to put up a front-yard fence to prevent their clients from wandering. However, this is in violation of our CC&Rs and would certainly diminish the ambience of the neighborhood. Most TERI group homes are in more rural areas without CC&Rs, where they are separated by more land, where putting up fences is more typical, and where neighborhood children aren/Et playing directly in front of the home. The particular home purchased by TERI is on the perimeter of the neighborhood and has a larger lot; however, the interior lots in that area are very small and children frequently play in the front yards and streets. One has to question why TERI wishes to place the home here at all b. Greater negative impact on home values than in a rural area: Placing this type of group home in a high-density, expensive neighborhood has a far greater negative impact on home values than placing it in a rural neighborhood with large lots and no standardized requirements of construction, landscaping, and maintenance. Two home sales on the same street have already fallen through because of this, and at least one other would have, but it was too late. Bressi Ranch residents paid more to buy into this neighborhood because they believed the stricter CC&Rs and Homeowners Association would help protect their home values, as well as provide a safe environment for their families. Yet we/Ere told that the group home is essentially exempt from these requirements. We have been placed in the catch-22 situation of having a large fence surrounding the property, thus violating the CC&Rs and the ambiance of the community, or allowing group home residents to roam freely around the ne! ighborhood despite the fact that they are supposed to be fenced in. Once again, these problems wouldn/Et exist if the home were simply placed in a rural large-lot area of town. 3. Failure to protect residents of Bressi Ranch: The city government failed in its most basic responsibility: to protect residents. Our Homeowners Association was not even informed until after the home had closed escrow. The city accepted verbal promises of light-impact use of the property (oonly high functioning autistic individualso) yet required nothing in writing. In fact, the permits granted to TERf allow even the highest risk clients to be housed in this group home. Although residents of the group home cannot be assumed to be criminals or sex offenders, there is a reason they are not allowed freedom of movement. We doubt that it is solely for their own protection. What do we want? We want our children (and ourselves) to be safe, our tax money to be spent wisely, and our home values to be protected to the extent reasonably possible. This means the home cannot be located within Bressi Ranch or other similar neighborhoods. We would like the city to do everything within its power to cause TERI to use the money wisely and build/buy into a rural less-expensive location. If the above were truly impossible, we would like the city to do everything within its power to assure that TERI is legally required (rather than just giving verbal assurances) to limit the residents of this home to those with no proclivity toward criminal or sexual offenses, and no indication that they might be dangerous to others. If this requirement is not possible, then they should be legally required to stay away from all the park areas and the clubhouse/pool facilities at all times. Failure to abide by such legal requirements should be cause for removal of their license to operate the home. This is not about discrimination. Bressi Ranch happily includes a multi-racial, multi-cultural population, affordable housing (condominiums), and soon-to-be-built senior housing and a Boys and Girls Club. It is about public safety, misuse of taxpayer dollars, enforcement of the CC&Rs, and protection of home values in our neighborhood. Carlsbad rightfully prides itself in creating and maintaining a community that is the envy of others. In this instance, however, the City Council really dropped the ball u and the residents of Bressi Ranch are paying the price. David L. and Linda J. Quinby David & Linda Quinby 2551 Ingleton Avenue Carlsbad, CA 92009-3060 USA quinby2@att.net Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 5.1; .NET CLR 2.0.50727; .NETCLR 1.1.4322) 75.36.44.84 From: <joe.obergfell@yahoo.com> To: <Council@[205.142.109.13]> Date: 01/06/2009 12:28 PM Subject: CITY OF CARLSBAD | CONTACT US A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: Attn: City Council Members, First of all I would like to thank you for attending the Bressi Ranch meeting last night. I just want to reiterate the importance of this matter with Bressi Ranch and TERI, Inc. to the City of Carlsbad. This really has nothing to do with discrimation, but has all to do with the safety of our children and your financial management. I am honestly living in fear with the uncertainty and unknown of the Bressi Ranch neighborhood. I will not let my 7, 6 and 4 year old out of my sight after what I learned in yesterdays meeting. The City and TERI, Inc owe us answers NOW! Who are the people moving into the home, are they autistic, mentally retarded, is it extreme, do they have dual diagnosis. I am afraid for my family and I should not feel that way living in a Luxury community. If this is so beneficial why has TERI Inc not addressed the howeowners, why has the City not notified us of the great news??? Secondly, the CDBG and HUD totaling $1,377,900 to TERI is an ultimate disgrace to the City of Carlsbad. You have used our tax dollars and federal money to purchase a luxury home for 4-6 individuals without a single stipulation other then it must be bought in Carlsbad. This funding could have housed 12-18 mentally disabled indivduals with some simple oversight and regulations. In reading CDBG and HUD regulations it should be used to enhance lower income neighborhoods or enhance slums - this is effectively driving down the value of the entire Bressi Ranch community. I am extremly disappointed with the City of Carlsbad's viewpoint with this situation and feel you made a mistake on management and left the problem on the laps of the Bressi Ranch homeowners. I realize there are state laws and regualtions to abide by, but did you honestly abide by the federal law with CDBG and HUD in giving $1.4M to TERI Inc to purchase a luxury home for 4-6 people. If taxpayers new this information I am sure they would be outraged. In addition if anyone of your kids or grandkids lived directly next door to a TERI house without knowledge or understanding of who occupied it I am sure you would not be able to sleep at night, just like the Bressi Ranch community will not sleep until this is resolved. Joe Obergfell 6222 Topiary St. Carlsbad, CA joe.obergfell@yahoo.com Mozilla/4.0 (compatible; MSIE 6.0; Windows NT 5.1; SV1; .NET CLR 1.1.4322; .NET CLR 2.0.50727) 12.1.219.177 Page 1 of 1 Council Internet Mailbox - Bressi Ranch From: <lewisclan4@aol.com> To: <council@ci.carlsbad.ca.us> Date: 12/16/2008 11:56 AM Subject: Bressi Ranch I just recieved a email about the shared homes with mentaly chalanged poeple living in our neighborhood. I feel this would be a big mistake and also devalue our homes as well. I understand times are tough but this is not a good solution for a up scale community like Bressi Ranch. I also have children at home and they play at the park and if you have little kids and adult handicaped adults that are mentally kids.The kids will stay away from the parks or pool or going for walks while the adult children are out side.Often times these homes are not run by trained or licensed or enough poeple to supervise them at all times. If this happens I will be putting my home on the market!!!!!!!!!! Dairy 1 Lewis 6307 Di Vita Dr. Carlsbad, CA. 92009 Listen to 350+ music, sports, & news radio static ns - including songs for the holidays - FREE while you browse. Start Listening Now! file://C:\Documents and Settines\Klinb\Local Settinps\Temn\YParnwkM4Q47Q7^rTW.n m/t From: skip reed <skpreed@yahoo.com> To: <council@ci.carlsbad.ca.us> Date: 12/10/2008 9:47 PM Subject: TERI house in Bressi Ranch Hello, My name is Skip Reed and I live at 2740 Palmetto Drive. I am writing this email in opposition to the TERI house that is proposed in Bressi Ranch. I am a homeowner in Bressi Ranch and I have two young children. I was never notified by the City of Carlsbad about the proposed TERI house. In the future I hope that you will notify all affected parties prior to making any decisions. I feel that this type of residence does not fit in our community. As a Firefighter, I respond to these types of homes daily. In my experience regardless of whom owns the home, private owner or a foundation; these homes tend to be very lucrative. The staff employed by these homes tend to be poorly trained which puts an added stress on your emergency system. Staff tends to rely on 911 to solve all of their problems. Quickly they become one of our "frequent fliers". The calls range from medical aids (both legitimate and non legitimate), assaults, and even structure fires. Safety resources, both police and fire, will be tied up unnecessarily because of this home. The emergencies and the actual emergency response to such emergencies will be an unwelcome addition to our peacefully neighborhood. As a parent and homeowner I fear that this may be the beginning of something that will drag our neighborhood down. How many more of these homes do you plan on approving? Has any consideration been given to the demographics of this neighborhood? We are a young neighborhood with many small children. Would this home be a better fit for a mature neighborhood? What are the requirements of notification? Does this violate the Home Owners Association Policies in any way? Bressi Ranch was developed as an inclusive diversified community. We have affordable housing in the form of attached condominiums (via City of Carlsbad Silent Second) and a plan for assisted living complex. We have done our part to diversify this part of Carlsbad. We all knew when we bought homes here we would live in such a community. Please don't take advantage of our willingness to include to the point where we want to exclude. Sincerely, Skip Reed 2740 Palmetto Drive 268-1049 AGENDA ITEM # c: Mayor City Council City Manager From: <tmundy@roadrunner.com> City Attorney To: <Council@[205.142.109.13]> CityClerk Date: 02/10/2009 2:00 PM ?EY Subject: CITY OF CARLSBAD | CONTACT US ' fTMtt A visitor to the City of Carlsbad Web site has completed and posted the "Contact Us" form to department, City Council. FOR SECURITY REASONS, DO NOT CHANGE THE SUBJECT LINE. Below, please find the information that was submitted: Re Bressi Ranch TERI Group home, I realize you have had feedback from the community regarding TERI house in Bressi Ranch. Sol will keep this short. I am extremely disturbed by the lack of oversight the city and federal goverment have over the use of our taxpayer dollars. The apparent misappropriation of funds and the lack of financial transparency of TERI Inc. as a NON PROFIT organization is reprehensible. In these economic times it is imperative that we as a people accept personal liablility for our situation and take a hard look at EVERY expenditure. How can we get the best for our dollar. Over 1 million dollars for 4 people? This purchase is not in keeping with the intent of the grant and is a misappropriation of taxpayer money. The drop in surrounding home values and loss of property tax REVENUES from that home and the surrounding homes is a direct result of the City's lack of oversight. You have greatly hurt the City as a whole and have decreased your taxable base with the purchase made from this one Grant. I hope you will take responsibility and pursue the truth and in turn regain the trust we have put in you to be fair and work for the City as a whole. Thank you for your time. Teresa Mundy Teresa Mundy Carlsbad, Ca 92009 tmundy@roadrunner.com Mozilla/4.0 (compatible; MSIE 7.0; Windows NT 5.1; .NET CLR 1.1.4322; lnfoPath.2) 76.176.126.196 FEB-10-a009 13:3E From: To:7219S7E CITY OF OCEAIMSIDE MARGERY M. PIERCE NEIGHBORHOOD DIRECTOR SERVICES DEPARTMENT February 9, 2009 Carlsbad City Council 1200 Carlsbad Village Drive Carlsbad CA 92008 Re: T. E.R.I., Inc. and Bressi Ranch Mayor Lewis and Members of the Carlsbad City Council: The City of Oceanside has a long and very positive relationship with the T.E.R.I. organization: • The administrative offices, adult day program facilities, a school for children with developmental disabilities and a thrift store are all located in the City of Oceanside. • The City provided federal HOME funds to T.E.R.I. for a group home for six developmentally disabled adults in a single-family residential area in the City. • The City has provided Community Development Block Grant funds to T.E.R.I. for improvements to the music therapy room and outdoor enrichment area at the day program center in Oceanside. • T.E.R.I. has a booth to sell arts and crafts at the weekly Oceanside Farmer's Market; four to six clients are there each week with a T.E.R.I. staff person. • Residents from one of the T.E.R.I. group homes have participated in the annual volunteer-based one day neighborhood improvement program. We have received no complaints concerning residents at the group home in Oceanside or the activities at the day program center. The City makes an annual monitoring visit to T.E.R.I. and reviews the agency's annual financial audit as required by regulations governing the CDBG and HOME programs; no findings or warnings have resulted from these visits. We are not aware of any negative reports or findings from similar visits by State of California licensing authorities. The City of Oceanside believes that the T.E.R.I. organization provides a very valuable service to families throughout North San Diego County, and that the leadership and staff of T.E.R.I. provide quality care to the children, youth and adults placed In their care. You are most welcome to visit their facilities in Oceanside in order to learn more about their programs and the people they serve. Sincerely, Margery M. Pierce Director, Neighborhood Services NEVADA STREET ANNEX 300 NORTH COAST HIGHWAY OCEANSIDE. CA 92054 (760)436-3360 FAX (760) 757-9076 The following were violations/deficiencies obtained from the TERI Inc. casefile at Community Care Licensing: The violations we will provide dates back to 2002 and as most recent as last October 2008. 10/1/08 82075A/Type A violation: TERI Inc. failed to inform CCL of injury in community under ADP Supervision where male client had a badly cut bleeding lip that required 3 stitches. It took 2 hours for client to be seen by emergency personnel. Incident actually happened since 9/17/08. 10/7/08:Director understands that either 911 should have been called or staff should have taken immediate action. New protocol had to be submitted on 10/10/08 outlining accidents/incidents and reporting procedures. 8/20/08 Section 80072 A 3 violation: PERSONAL RIGHTS-Staff violated clients personal rights by humiliating client by throwing his hat on the cupboard and agitating client with artificial flowers. Staff terminated and TERI employees required to attend "inservice." 2/6/08 PHYSICAL ABUSE- Unannounced visit/investigation of a complaint received regarding physical abuse of client by staff. Complaint was "inconclusive." 11/7/07 Client broke foot/ankle at the program but it was not determined if incident occurred. Similar incident reported on 11/14/07. No deficiencies noted. 12/6/07 TERI Inc. hired staff that was EXCLUDED from working in any community care facility since 2003 and that staff was later terminated. This is negligence on the part of the TERI Inc. 10/30/07 PHYSICAL ABUSE-Staff pinched client on the arm/side to get client to stand up, and step on other clients feet to get them to clam down. Staff was counseled to report any concerns to their supervisors and attend human, rights training. 8/23/07 TYPE B/section 80061 1 D/Reporting Requirements-Facility failed to report several incidents regarding containments that took place with client. 5/H707 TypeA/seetion 80072^ G^Vtolation/PERSONAL RIGHTS- Female-client- had latex gloves placed on her hands to keep her from digging into her skin which was NOT allowable form of protection. Client mobility shall not be restricted. If client needs protective device for self-abusive behavior, day program shall request exception from CCL. Regional Center and physician would also have to provide approval documentation. 10/25/05 Title 22 Type A/section 88087A violation-Client ingested small amount of mouse pellet that was in the classroom. 9/2/05 Title 22 Type A violation/section 80072(a)(3)-PERSONAL RIGHTS- Staff inappropriately hit a consumer while transporting clients on the bus. Staff was terminated. 2/4/05 Type A/section 80010 A Limitations on Capacity and Ambulatory Status-At time of visit licensing staff (LPA) counted 27 consumers at day program. License capacity is 30. Facility did not adhere to the license capacity. 11/1/02 Title 22 Type B/section 80061-Reporting Requirements-Facility inadvertently failed to report the incident took on 10/17/02 where a client riding in the TERI van was struck in the head by another client with a seat belt. This should have been reported the next business day and there was no written follow-up. The contracted signed by the City of Carlsbad is a legally binding contract with clear stipulation that if TERI was found in violation of the award, which we clearly the case, there would be a reversion of assets, requiring TERI to transfer any accounts receivable attributable to the use of the CDBG funds to the City as well as dispose of the property in a manner that results in the City being reimbursed in the amount of the current fair market value of the property. ANZA HOUSE 1736 Anza Ave. Vista, CA 92084 Tel: 760-941-4046 GRACE HOUSE 2507 Hibiscus Ave. Vista, CA 92081 -Tel: 760-598-0305 MARSHALL HOUSE 758 South Melrose Vista, CA 92081 Tel: 760-940-9337 MONTGOMERY HOUSE 1658 Montgomery Dr. Vista, CA 92084 Tel: 760-630-3450 VIA RIO HOUSE 1262 Via Encinas Dr. Fallbrook, CA 92028 Tel: 760-731-2157 CARLO HOUSE 411 Carlo St. San Marcos, CA 92078 Tel: 760-598-0305 LA COSTA HOUSE 6433 Flamenco St. Carlsbad, CA 92009 TH 760-43R-074I MCNEALY HOUSE 4602 AUende Ave Oceanside, CA 92057 Tel 760-722-4099 ORIENTE HOUSE 3081 Oriente Dr. Vista, CA 92084 Tel: 760-630-9089 VISTA HOUSE 1768 Monte Mar Rd. Vista, CA 92084 760-945-4971 SO » :InstructoiBehaviorDirectorjar •OH.H JH >?CupInstructor*1? s»o «-•p I!i ite • H •'*?••t (-0o n aft 0 Seeing opportunities, Removing limitations, Imparting hope January 20, 2006 Mr. Tony Girolami Community Care Licensing 7S7S Metropolitan T> Suite 10Q REC F: VED 2006 STATL. ,!AL SERVICES CCL-SA,NO!Li.;j._i;.'jR CARE OFFICE San Diego, CA 92108 Dear Tony: I am writing to inform Community Care Licensing of a change in address for our administrative office which is also the mailing address for our Community Care licensed Adult Day Programs. The new address is: TERI, Inc. (Training, Education, and Research Institute 251 Airport Road Oceanside, CA. 92054 Phone:(760)721-1706 Fax: (760)721-9872 www. teriinc.org Thank-you! Sincerely- Krysti DeZonia Director of Education and Research TERI, Inc. RECEIVED FEB -1 2006 STATE DEFT. OF SUi>\L'o;;-:-u' CCL-SAN DIEGO SEh;!OR CAP;; i> 3225 Roymar Road • Oceanside, California 92054 (760) 721-1706 • Fax: (760) 721-9872 • www.teriinc.org STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT See other side for explanation of form. REFER TO CALIFORNIA DEPARTMENT OF SOCIAL f.CHV! V COMMUNITY CARPWEW8IN©" 7575 METROPOLITAN DR., STE. 10< SAN DIEGO, CALIFORNIA 92108 FACILITY NAME DIRECTOR /fe FACILITY NUMBEl FACILITY TYPE ADDRESS TELEPHONE CAPACITY CENSUS DATE TYPE OF VISIT: D OFFICE D EVALUATION D MANAGEMENT Br-pRELICENSING D ANNUAL D FOLLOW-UP B^METWITH S-TfNNOUNCED D UNANNOUNCED TIME VISIT BEGAN TIME COMPLETEPy J^ O^ DEFICIENCY INFORMATION FORTHISPAGE: D Type A y"N*o Deficiency Cited D TypeB CIVIL PENALTY INFORMATION: D Penalty Assessed D Penalty Notice Given D Penalty Cleared COMMENTS/DEFICIENCIES PLAN OF CORRECTIONS (POC«)POC DUE DATE Failure to correct the above cited deflciency(les), on or before the Plan of Correction (POC) due date, may result In a civil penalty assessment of $50 per day (Family Child Care Homes, Foster Family Homes and all governmental agencies are exempt). understand my licensing appeal rights as ,explained on 4ne baet^eftfris-fornr LIC BOfl (4/99)pages To Clear Additional POC's Use Button on 809-D STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CLEARED DEFICIENCIES CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92108 FACILITY NAME: T.E.R.I INC, CENTER FOR ART AND ADULT EDUCATION FACILITY NUMBER: 374600992 VISIT DATE: 10/01/2008 POC Due Date / Section Number 10/07/2008 82075 A 10/01/2008 Section Cited 82072 9 Section Cited Section Cited PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Director understands that either 911 should have been called or staff should have taken client immediately to emergency. One Staff could have stayed with client and others could have returned to ADP on the van. It took approx. 2 hrs for client to be seen by emergecy personnel . New protocal to be subbmitted by 10/7/08 Director realizes that client should have received immediate medicatl attention. Date Cleared / Comments 1 2 3 4 1 2 3 4 •\ 2 3 4 •\ 2 3 4 10/10/2008 New protocal was submitted on 10/10/08 outlining accidents/incidents and reporting procedures STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res. 7575 Metropolitan Dr Ste 109 San Diego, CA 92108 10/14/2008 I.E.R.I INC, CENTER FOR ART AND ADULT EDUCATION 374600992 251 AIRPORT RD ,OCEANSIDE, CA 92054 Letter of Deficiency Citations Cleared Dear Licensee, The following deficiencies, initially cited during a visit on 10/01/2008, have been cleared: Section Cited: 82075 A Date Due: 10/07/2008 Plan of Correction: Director understands that either 911 should have been called or staff should have taken client immediately to emergency. One Staff could Corrections: New protocal was submitted on 10/10/08 outlining accidents/incidents Clearance Date: 10/10/2008 have stayed with client and others could have returned to ADP on the ancj reporting procedures van. It took approx. 2 hrs for client to be seen by emergecy personnel . New protocal to be subbmitted by 10/7/08 LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) 481-0844 DATE: 10/14/2008 This report must be available at Child Care and Group Home facilities for public review for 3 years. Cleared POC Letter (FAS) • (04/05)Page:1 of 1 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Olego, CA 92106 This is an official report of an unannounced visit/investigation of a complaint received in our office on 09/24/2008 and conducted by Evaluator Tony Girolami PUBLIC COMPLAINT CONTROL NUMBER: 08-AR-20080924110508 FACILITY NAME: ADMINISTRATOR: ADDRESS: CITY: CAPACITY: MET WITH: T.E.R.I INC, CENTER FOR ART EDUCATION TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 200 Teresa Martin and Greg Snaer AND ADULT STATE: CENSUS: 129 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME VISIT BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 10/01/2008 11:30 AM 12:45 PM ALLEGATION(S): Care and Supervision - Client received injury in the Community under ADP Supervision and did not received immediate neccessary medical attention. INVESTIGATION FINDINGS: 1 2 3 4 5 6 7 8 9 10 11 12 13 LPA is substantiating allegation. Staff Greg Snaer signed report. Male client recieved an injury in the Community under ADP hours. Clients were in San Marcos for the day where they often go for activities. Clients were cleaning up ready to return to licensed ADP. Male client was cleaning up his area and staff heard a crash. Male client came out of the shed with a badly cut bleeding lip. Staff Heather Baxter applied pressure to lip to stop bleeding. Other staff made phone calls to ADP to explain situation and inform them they will be returning to the program with a male client who received injury. When client was walking to the van lip began to bleed again. Client applied pressure to his own lip during the van ride home. Bleeding had stopped during van ride but began again when getting of the van and walking to the ADP. Nurse was awaiting client and applied first aid and gauze. Nurse believed client would need to see a Dr. and would probably need stiches . Board and Care staff was there to pick up client as normal. Board and Care staff found out about injury at that time. Board and Care staff returned home with client and took client to Drs. where client received three stiches. The following page list the Type 'A" violation Substantiated Estimated Days of Completion: SUPERVISOR'S NAME: Marina Stanic LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (714) 703-2840 TELEPHONE: (619)481-0844 DATE: 10/01/2008 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2008 Control Number 08-AR-20080924110508 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont) CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92108 FACILITY NAME: I.E.R.I INC, CENTER FOR ART AND ADULT EDUCATION DEFICIENCY INFORMATION FOR THIS PAGE: FACILITY NUMBER: 374600992 VISIT DATE: 10/01/2008 Deficiency Type POC Due Date / Section Number Type A 10/07/2008 Section Cited 82075 A Type A 10/01/2008 Section Cited 82072 9 DEFICIENCIES 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Health Related Services - Client received injury in che community during ADP hours but did not receive immediate medical attention. Staff did inform ADP of injury and were returning to program. Staff should have either called 911 in the community or taken him directly to the Drs. Personal Rights- client should have received immediate medical care. New policy shall be in place immediately. PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Director understands that either 91 1 should have been called or staff should have taken client immediately to emergency. One Staff could have stayed with client and others could have returned to ADP on the van. It took approx. 2 hrs for client to be seen by emergecy personnel . New protocal to be subbmitted by 1 0/7/08 Director realizes that client should have received immediate medicatl attention. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME: Marina Stanic LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (714) 703-2840 TELEPHONE: (619) 481-0844 DATE: 10/01/2008 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2008 W~ LIC9Q9S (FAS) - (06/04)Page: 2 of 2 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Or Ste 109 San Diego, CA 92108 FACILITY NAME: T.E.R.I INC, CENTER FOR ART AND ADULT FACILITY NUMBER:374600992 EDUCATION ADMINISTRATOR: TERESA MARTIN ADDRESS: 305 AIRPORT ROAD CITY: OCEANSIDE CAPACITY: 200 TYPE OF VISIT: Case Management MET WITH: Teresa Martin STATE: CA CENSUS: 129 UNANNOUNCED FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 775 (760)721-1706 92054 10/01/2008 12:34 PM 12:45 PM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 LPA is conducting case management visit to cite the facility for failing to inform CCL of incident which took place on 9/17/08. A male client was injured in the community under ADP supervisor Facility staff failed to report incident by phone by the next business day and wrriten documentation within seven days. Director Teresa martin supplied LPA with written report that was submitted to Regional Center. The following Type "B" violation is submitted on the following page. SUPERVISOR'S NAME: Marina Stanic LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (714) 703-2840 TELEPHONE: (619)481-0844 DATE: 10/01/2008 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2008 This report mustbe^avaHabte at Child^Care and^Group Home facilities for public reviewforTyears: LIC809 (FAS) - (06/04)Page: 1 0(2 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Or Ste 109 San Diego, CA 92108 FACILITY NAME: I.E.R.I INC, CENTER FOR ART AND ADULT EDUCATION DEFICIENCY INFORMATION FOR THIS PAGE: FACILITY NUMBER: 374600992 VISIT DATE: 10/01/2008 Deficiency Type POC Due Date / Section Number Type B 10/01/2008 Section Cited 82061 A 1 B DEFICIENCIES 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Reporting Requirements- Facility failed to inform CCL of incident that took place in the community where a male client had to receive three stiches. PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Report was given to LPA during visit. LPA shall receive incident report by the required time frame on the previous page. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME: Marina Stanic LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (714) 703-2840 TELEPHONE: (619)481-0844 DATE: 10/01/2008 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: C DATE: 10/01/2008 L1C809 (FAS) - (06/04)Page: 2 of 2 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92108 FACILITY NAME: T.E.R.I INC, CENTER FOR ART AND ADULT FACILITY NUMBER:374600992 ADMINISTRATOR: ADDRESS: CITY: CAPACITY: TYPE OF VISIT: MET WITH: EDUCATION TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 200 Case Management Terry Ehrhardt STATE: CA CENSUS: UNANNOUNCED FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 775 (760)721-1706 92054 08/20/2008 01:OOPM 01:30PM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 LPA Tony Girolami conducted case management visit to discuss the incident which was appropriately self reported by Terry Ehrhardt. Incident which was reported stated that three employees had violated the clients personal rights by humilitating client. A staff person was told by another staff to take away clients tub of blocks and his hat if he has behaviors. Staff followed these instructions but realized later that clients paperwork states that he should not be without these items at any time . On the same day, staff Staff # 1 witnessed Staff #2 throw clients hat up on the cupboard. When client became more agitated Staff #2 got some long stemmed artificial flowers and shook them in clients face. This is a violation of the clients personal rights and is a Title 22 Violation. Deficiency cited on the following page. Facility staff that was invovlved in this incident and other incidents such as this have been terminated. Asst. Director properly notified incident to CCL in a timely manner and appropriately terminated employees. SUPERVISOR'S NAME: Marina Stanic LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (714) 703-2840 TELEPHONE: (619) 481-0844 DATE: 08/20/2008 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: /I /) / DATE: 08/20/2008 Thi&report must be^avaifabte^aTCtitld Care arid Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04) paB»: 1 of 2 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan DrSte 109 San Diego, CA 92108 FACILITY NAME: T.E.R.I INC, CENTER FOR ART AND ADULT EDUCATION DEFICIENCY INFORMATION FOR THIS PAGE: FACILITY NUMBER: 374600992 VISIT DATE: 08/20/2008 Deficiency Type POC Due Date / Section Number Type A 08/20/2008 Section Cited 80072 A 3 DEFICIENCIES \ I I 5 6 1 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Personal Rights - Staff violated clients personal rights by humiliating client by throwing his hat on the cupboard and agitating client with artificial flowers. Staff to treat clients with respect at all times. PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 This has been corrected with the termination of staff. Licensee has begun an inservice which half of TERI employees have attended and the other half to complete inservice by Tuesday 8/26/08. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME: Marina Stanic LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (714) 703-2840 TELEPHONE: (619)481-0844 DATE: 08/20/2008 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: - / / /// DATE: 08/20/2008 LIC80S (FAS) - (06/04)Page: 2 of 2 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92108 This is an official report of an unannounced visit/investigation of a complaint received in our office on 02/05/2008 and conducted by Evaluator Tony Girolami PUBLIC COMPLAINT CONTROL NUMBER: 08-AR-20080205092547 FACILITY NAME: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER ADMINISTRATOR: TERESA MARTIN ADDRESS: 305 AIRPORT ROAD CITY: OCEANSIDE STATE: CAPACITY: 200 CENSUS: 165 UNANNOUNCED MET WITH: Teresa Martin FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME VISIT BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 02/14/2008 10:45 AM 11:15 AM ALLEGATION(S): Physical Abuse INVESTIGATION FINDINGS: 1 2 3 4 5 6 7 8 9 10 11 12 13 This complaint is continuing from initial visit which was conducted on 2/6/08. On this day LPA Tony Girolami spoke Director Teresa Martin. Prior to today's visit LPA spoke with alleged abuser and other staff that currently works with alleged abuser. No staff other than the complainant has witnessed staff in question acting inappropriately with clients in care.. This complaint is Inconclusive. Inconclusive Estimated Days of Completion: SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) 76-2300 TELEPHONE: (619)481-0844 DATE: 02/14/2008 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: / DATE: 02/14/2008 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 1 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7578 Metropolitan Dr Ste 109 San Diego, CA 92108 This is an official report of an unannounced visit/investigation of a complaint received in our office on 02/05/2008 and conducted by Evaluator Tony Girolami CONFIDENTIAL COMPLAINT CONTROL NUMBER: 08-AR-20080205092547 FACILITY NAME: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER ADMINISTRATOR: TERESA MARTIN ADDRESS: 305 AIRPORT ROAD CITY: OCEANSIDE STATE: CAPACITY: 200 CENSUS: 125 UNANNOUNCED MET WITH: Teresa Martin FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME VISIT BEGAN: TIME COMPLETED: 374600992 775 (760) 721-1706 92054 02/06/2008 09:30 AM 11:00 AM ALLEGATION(S): 1 physical abuse 2 3 4 5 6 7 8 9 INV 1 2 3 4 5 6 7 8 9 10 11 12 13 •STIGATION FINDINGS: LPA conducted complaint investigation. LPA interviewed staff LPA will conclude investigation within 30 days Needs Further Investigation Estimated Days of Completion: 30 days SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) 76-2300 TELEPHONE: (619) 481-0844 DATE: 02/06/2008 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2008 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 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego. CA 92008 FACILITY NAME: ADMINISTRATOR: ADDRESS: CITY: CAPACITY: TYPE OF VISIT: MET WITH: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 200 Case Management Terry Ehrhardt STATE: CA CENSUS: 168 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760) 721-1706 92054 12/06/2007 10:25 AM 10:45 AM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 LPA Tony Girolami is conducting case management visit to follow up on 11/14/07 case management visit discussing a client who may have broke their foot/ankle at day program. After speaking with staff on 11/14/07 and staff since via phone, LPA can not determine where the broken foot/ankle ocurred. No deficinceis noted. SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) - 481-0844 DATE: 12/06/2007 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: ^ /} DATE: 12/06/2007 This report must be availablejatChild Care and Group Hom&faeUtties LICSOS (FAS) - |06/04| for 3^years^ Page: 1 °' 1 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92008 FACILITY NAME: ADMINISTRATOR: ADDRESS: CITY: CAPACITY: TYPE OF VISIT: MET WITH: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 200 Case Management Terry Ehrhardt STATE: CA CENSUS: 168 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 12/06/2007 10:16AM 10:30 AM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 LPA Tony Girolami conducted case management visit to discuss an employee who was excluded from working in any community care facility in 2003. LPA gave a copy of the accusation and Decision and Order to Terry Ehrhardt. TERI Inc. properly fingerprinted client and hired as they received a "no criminal record" response. Later it was observed that client was to be excluded from any facility since 2003. LPA contacted facility by phone and requested Decision and Order from Sacramento. After discussing Decision and Order with TERI Personnel, facility properly terminated staff immediately on 12/5/07. No deficiencies noted on this day. SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) - 481-0844 DATE: 12/06/2007 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: -, r\ DATE: 12/06/2007 This report must be available at Child Care_a_nd Group Home f a cMLei foe public review -fof-3-yeafs-.- LIC309 (FAS) • (06/04)Page: 1 of 1 STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego RM., 7575 Metropolitan Or Ste 109 S»n Dl»go, CA 92008 FACILITY NAME:T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER ADMINISTRATOR: TERESA MARTIN ADDRESS: CITY: CAPACITY: TYPE OF VISIT: MET WITH: 305 AIRPORT ROAD OCEANSIDE 200 Case Management Terry Ehrhardt STATE: CA CENSUS: 100 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 11/14/2007 11:20 AM 12:10 PM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 LPA Tony Girolami is conducting a case management visit to discuss an incident where a board and care reported that a female client had broken her foot. Board and care is stating that client appeared fine when she left for day program. Incident reported by Board and Care states that when female client returned home from program on 11/1/07 she was was trying not to put any weight on her right side. Female has a broken foot/ankle. Staff from Board and Care called Day Program and spoke with clients direct care staff Tammy Galvan who stated that client had a good day and did that she did not notice anything unusual. On this day LPA was not able to speak with staff Tammy Galvan but did speak to Terry Ehrhardt who stated to LPA that she saw client go on the bus the day in question and client did not appear to be having any problems. LPA will speak with direct care staff and staff and board and care at a later date. No deficiencies on this day.. SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) - 481-0844 DATE: 11/14/2007 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2007 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809(FAS)-(0«e4)- ~ Pafle: STAT . 17 CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION Swi Dtago RM., 7575 Metropolitan Or SW 109 San Dl«go, CA »20M FACILITY NAME: ADMINISTRATOR: ADDRESS: CITY: CAPACITY: TYPE OF VISIT: MET WITH: T.E.R.I., INC. OUR WAY TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 200 Case Management Lori Connerley DEVELOPMENT CENTER STATE: CA CENSUS: UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 10/30/2007 09:35 AM 10:55 AM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Tony Girolami conducted case management visit to look in to incident which was reported by T.E.R.I. Inc. in early October. Incident states that staff (S-1) witness staff (S-2) lightly pinch a client on the arm/side to get client to stand up, and step on other clients feet to get them to calm down. On this day LPA spoke with several staff. LPA did not receive any sufficeint information that (S-2) acted inappropriately with clients. Both staff have been counseled to report any concerns to their supervisors and will attend human rights training. No deficiency noted on this day SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) -481-0844 DATE: 10/30/2007 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: # ,/-) DATE: 10/30/2007 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (OW04) STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92008 This is an official report of an unannounced visit/investigation of a complaint received in our office on 08/16/2007 and conducted by Evaluator Tony Girolami PUBLIC COMPLAINT CONTROL NUMBER: 08-AR-20070816154114 FACILITY NAME: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER ADMINISTRATOR: TERESA MARTIN ADDRESS: 305 AIRPORT ROAD CITY: OCEANSIDE STATE: CAPACITY: 200 CENSUS: UNANNOUNCED MET WITH: Teri Ehrhardt FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME VISIT BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 08/23/2007 09:30 AM 11:15AM ALLEGATION(S): Female client was observed with bruising on upper legs and side, possible due to restraints. INVESTIGATION FINDINGS: 1 2 3 4 5 6 7 8 9 10 11 12 13 LPA Tony Girolami spoke with Teri Ehrhardt, Asst. Director Day Program, Tammy Galvan, Supervisor and staff Susana Tapia. LPA viewed where client was attending program on this day. Staff ratios were within regulation. Allegation of bruising appears to be self inflicted during program as client's behavior escalates to throwing, biting and hitting themselves. Staff has performed Assaultive Behavior Intervention Technique (ABIT) several times in the month of July due to these behaviors. LPA received no information that would substantiate that bruises on the upper leges and side were from the ABIT. LPA did discuss the frequency of ABIT's being performed and the length of time for each instance. Staff performed ABIT on LPA at LPA's request. A psychologist will be meeting with staff and client today to observe client's behavior. Facility has now a sensory program in place that will hopefully assist in the decrease of client behaviors, and staff will continue to utilize re-direction as a primary way of de-escalation. Complaint is Inconclusive. Facility is cited a Type B violation for not reporting these incidents to CCL.. Inconclusive Estimated Days of Completion: SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619)-767-2300 TELEPHONE: (619) - 481-0844 DATE: 08/23/2007 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: "~" DATE: 08/23/2007 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 ; Control Number 08-AR-20070816154114 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY COMPLAINT INVESTIGATION REPORT (Cont) CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92008 FACILITY NAME: I.E.R.I., INC. OUR WAY DEVELOPMENT CENTER DEFICIENCY INFORMATION FOR THIS PAGE: FACILITY NUMBER: 374600992 VISIT DATE: 08/23/2007 Deficiency Type POC Due Date / Section Number Type B 08/23/2007 Section Cited 80061 1 D DEFICIENCIES 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Reporting Requirements. - Facility failed to report several incidents regarding containments that took place with client. Regional Center was informed. Teri Ehrhardt was not aware that containments needed to be reported. PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 This has been corrected as incidents since July have been reported. Corrected. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME: Jim Wallace LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) - 481-0844 DATE: 08/23/2007 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: a s ^ // DATE: 08/23/2007 LIC9099 (FAS) - (06/04)Page: 2 of 2 STATE O; CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Dtago R«*., 7576 Matropoltan Dr Sto 108 S«n Dteao, CA 92006 FACILITY NAME: ADMINISTRATOR: ADDRESS: CITY: CAPACITY: TYPE OF VISIT: MET WITH: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 200 Case Management - Deficiencies Terry Ehrhardt STATE: CA CENSUS: UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760)721-1706 92054 05/11/2007 09: 15 AM 10:00 AM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 LPA Tony Girolami is conducting case management visit due to a personal rights violation that occurred at day program in early April. It was observed by reporting party that a female client had latex gloves place on her hands to keep her from digging tnto her skin on her face, hands and legs. Female client has a long history of this behavior, however, day program does not have an exception for this consumer to have protective devices, and if exception is approved in the future with proper documentation, latex glove would not be an allowable form of protection. The following page list a Type "A" violation. SUPERVISOR'S NAME: Shelley High LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) -767-2326 DATE: 05/11/2007 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: 4 // DATE: 05/11/2007 This report must be available at Child Care and Group Home facilities for public review for 3 years. LJC809 (FAS)-(06/04) Page: 1 of 1 STATE C,F CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cent) CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Dtego Rn., 7676 Metropolitan Dr St« 10» San Olago,CA 92008 FACILITY NAME: T.E.R.I., INC. OUR WAY DEVELOPMENT CENTER DEFICIENCY INFORMATION FOR THIS PAGE: FACILITY NUMBER: 374600992 VISIT DATE: 05/11/2007 Deficiency Type POC Due Date / Section Number Type A 05/11/2007 Section Cited 80072 G DEFICIENCIES 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Personal Rights - Client mobility shall not be restricted. If a client needs protective devices for self-abusive behavior, day program shall request exception from CCL. Regional Center and physician would also have to provide approval documentation. PLAN OF CORRECTIONS(POCs) 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 This has been corrected. Staff has been informed not to use latex gloves on consumers. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment SUPERVISOR'S NAME: Shelley High LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) -767-2326 DATE: 05/11/2007 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE:/ r\ A DATE: 05/11/2007 LIC809 (FAS)-(06/04)Page: 1 of 1 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Dtogo R«., 7575 Metropolitan Or Sto109 San Dtogo, CA »200» ' FACILITY NAME: T.E.R.I., INC. OUR WAY ADMINISTRATOR: TERESA MARTIN ADDRESS: 305 AIRPORT ROAD CITY: OCEANSIDE CAPACITY: 135 TYPE OF VISIT: Prelicensing MET WITH: Terry Ehrhardt DEVELOPMENT CENTER STATE: CA CENSUS: 50 UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760) 721-1706 92054 01/17/2007 09:45 AM 11:00 AM NARRATIVE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Pre-licensing visit was conducted on this day to increase capacity at ADC to 200 from 135 Sixteen (16) clients may be non-ambulatory. Facility is currently licensed and has added additional activity rooms, staff offices and bathrooms. Facility added eight (8) toilets and four (4) sinks. Hot water was tested at 110 degrees. Medications will be stored in locked cabinet in each program where clients are residing. Poison and toxics will be locked in three different locked storage rooms. Fire clearance was granted and received on 1/11/07. SUPERVISOR'S NAME: Shelley High LICENSING EVALUATOR NAME: Tony Girolami LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619) -767-2300 TELEPHONE: (619) -767-2326 DATE: 01/17/2007 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2007 This report must be available at Child Care and Groupjtome facilities for public review for 3 yearst LIC809 (FAS)-(06/04) Page: 1 of 1 STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION San Diego Res., 7575 Metropolitan Dr Ste 109 San Diego, CA 92008 FACILITY NAME: DIRECTOR: ADDRESS: CITY: CAPACITY: TYPE OF VISIT. MET WITH: T.E.R.I., INC. OUR WAY TERESA MARTIN 305 AIRPORT ROAD OCEANSIDE 135 Case Management Teri Earhardt DEVELOPMENT CENTER STATE: CA CENSUS: UNANNOUNCED FACILITY NUMBER: FACILITY TYPE: TELEPHONE: ZIP CODE: DATE: TIME BEGAN: TIME COMPLETED: 374600992 775 (760) 433-6024 92054 10/27/2005 01:00 PM 02:00 PM DEFICIENCY INFORMATION FOR THIS PAGE: Type A CIVIL PENALTY INFORMATION: Not Applicable COMMENTS/DEFICIENCIES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 LPA Tony Girolami conducted case management visit to discuss incident that ocurred on A client accidentaly ingested a very small amount mouse pellet that was in the classroom placed in the classroom over the weekend to repel a rodent. One pellet was overlooked. 10/17/05. Pellets were On Monday morning afternoon staff noticed that a partial pellet was missing and noticed a female client had a green substance on the side of her mouth. Staff contacted poison control and properly informed The following is a Title 22 Type A violation: CCL of incident. CDin~~ C3 j" CO .'. . CO en— j ' Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. SUPERVISOR'S NAME: Shelley High LICENSING EVALUATOR NAME: Tony Girol LICENSING EVALUATOR SIGNATURE: TELEPHONE: (619)-767-2300 TELEPHONE: (619)-767-2326 DATE: 10/27/2005 I acknowledge receipt of this form and understand my licensing appeal rigr FACILITY REPRESENTATIVE SIGNATURE ~ as explained and received. ATE: 10/27/2005 LJCao.9 (£AS> -(06/04)-Page: 1 of 2