<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 134604792
Report Date: 07/10/2025
Date Signed: 07/10/2025 04:48:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/03/2025 and conducted by Evaluator David Roman
COMPLAINT CONTROL NUMBER: 08-AS-20250403161345
FACILITY NAME:MACKENZIE CARE HOME IIIFACILITY NUMBER:
134604792
ADMINISTRATOR:HAMPTON, DEREKFACILITY TYPE:
735
ADDRESS:987 SHELBIE AVE.TELEPHONE:
(760) 460-1129
CITY:BRAWLEYSTATE: CAZIP CODE:
92227
CAPACITY:4CENSUS: 3DATE:
07/10/2025
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Direct Support Professional, Presly LiraTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not dispensing medication as prescribed.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) David Roman conducted an unannounced visit to deliver findings in the above complaint allegation. LPA identified himself and discussed the purpose of the visit with Facility Administrator, Raquel Preece
.
On April 03, 2025, Community Care Licensing Division (CCLD) received a complaint alleging facility staff are not dispensing medication as prescribed. According to the allegation, facility staff are not dispensing medication as prescribed to R1. During the investigation, LPA D. Roman collected pertinent facility records and conducted interviews with staff. Interviews and records reviewed revealed information pertient to accurate documentation of medication for R1.

Based on evidence obtained, the preponderance of evidence standard was not met, therefore, the allegation is unsubstantiated. An exit interview was conducted with Facility Administrator, Raquel Preece, to whom a copy of this report and Licensee/Appeals Rights (LIC 9058) were provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: David Roman
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
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