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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331800237
Report Date: 04/18/2024
Date Signed: 04/18/2024 11:36:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/15/2024 and conducted by Evaluator Melody Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240415162822
FACILITY NAME:GABRIELA CARE HOME INCFACILITY NUMBER:
331800237
ADMINISTRATOR:CALILUNG, RESTITUTOFACILITY TYPE:
740
ADDRESS:1717 TAMARRON DRIVETELEPHONE:
(714) 906-6046
CITY:CORONASTATE: CAZIP CODE:
92883
CAPACITY:6CENSUS: 4DATE:
04/18/2024
UNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Licensee/Administrator Restituto "Resty" Calilung and House Manager Bene MolintaTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Staff do not provide quality meals to residents in care.
Staff do not ensure residents' rooms are kept clean.
INVESTIGATION FINDINGS:
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On 04/18/2024 at 08:20 AM, Licensing Program Analyst (LPA) Melody Brown conducted an unannounced visit to the facility to commence a complaint investigation. LPA Brown was greeted and granted entrance by a staff member and LPA Brown met with House Manager Bene Molintas. LPA Brown identified herself and discussed the purpose of the visit and the elements of the allegations with House Manager Bene Molintas. Licensee/Administrator Restituto "Resty" Calilung arrived during the visit.

LPA Brown conducted a quick tour of the facility, interviewed residents and staffs, and obtained facility records. The investigation consisted of file review and interviews with relevant parties. The first allegation indicates that Staff do not provide quality meals to residents in care. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with four (4) of four (4) residents indicated that staffs at the facility are serving them good quality meals, and good portion of food for their breakfast, lunch and dinner. Residents interviewed revealed they don't have any complaints on their meals at the facility because staffs at the facility provide quality meals everyday. *** Continuation in LIC9099C ***
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody BrownTELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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
Control Number 56-AS-20240415162822
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: GABRIELA CARE HOME INC
FACILITY NUMBER: 331800237
VISIT DATE: 04/18/2024
NARRATIVE
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Residents interviewed reported that staffs were informing them of the facility menu every week. LPA brown unable to interview Resident #1 (R1) as R1 moved out at the facility on 04/13/2024. Interviews with four (4) of four staff indicated that they are providing quality meals to their residents everyday and no incident happened at the facility that they served poor quality meals to their residents. Staffs interviewed added that they are informing their residents of their facility menu every week. During the facility visit on 04/18/2024, LPA Brown observed that staffs at the facility provided nutritious breakfast to their residents as residents were served rice porridge with milk, mixed fruit and a choice of drink.

The second allegation indicates Staff do not ensure residents' rooms are kept clean. Interviews with four (4) of four (4) residents indicated that staffs at the facility are cleaning their room everyday and there's no incident that staffs at the facility did not ensure that their rooms are kept clean. Interviews with four (4) of four staff indicated that they are cleaning the residents room everyday and they always ensure that residents rooms are kept clean. Staffs interviews revealed that staffs are cleaning residents room twice a day, once in the morning and before bed time. During the facility visit on 04/18/2024, LPA Brown observed the resident rooms were kept clean.

Based on the evidence, the allegation that Staff do not provide quality meals to residents in care (Allegation #1), and Staff do not ensure residents' rooms are kept clean (Allegation #2) are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.


An exit interview was conducted where this report, LIC9099 was discussed and provided to Licensee/Administrator Restituto "Resty" Calilung.
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 202-6356
LICENSING EVALUATOR NAME: Melody BrownTELEPHONE: 951-897-2187
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2