331881164-12-15-2025-18-AS-RORN-DPMLWC-20251223080654

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881164
Report Date: 12/15/2025
Date Signed: 12/15/2025 03:47:55 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/23/2024 and conducted by Evaluator Mary G Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240123153651

FACILITY NAME:	RUBIO HOME		FACILITY NUMBER:	331881164
ADMINISTRATOR:	RODRIGUEZ, SHAYLA		FACILITY TYPE:	735
ADDRESS:	51800 AVENIDA RUBIO		TELEPHONE:	(760) 972-4194
CITY:	LA QUINTA	STATE: CA	ZIP CODE:	92253
CAPACITY:	4	CENSUS: 4	DATE:	12/15/2025
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Cesar Santiago - Direct Support Staff		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff are not reporting incidents involving residents as required.
Staff do not have appropriate training.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Flores conducted a subsequent complaint investigation visit regarding the above allegations. LPA met with Cesar Santiago and explained the reason for the visit.

The investigation consisted of the following: On 1/25/24 LPA Arreola conducted an initial complaint investigation visit. On 12/10/25 LPA Flores contacted Inland Regional Center Facility Liaison and facility’s administrator over the phone and requested pertaining documents. On 12/11/25 LPA Flores conducted interviews with 4 clients and 2 staff over the phone. On 12/15/25 LPA Flores conducted a subsequent complaint visit, interviewed 2 staff, and delivered findings.

The investigation revealed the following: Regarding allegation: Staff are not reporting incidents involving residents as required. It is alleged clients’ elopement and or behavioral incidents have not been reported to the appropriate agencies.
(CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20240123153651

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: RUBIO HOME	FACILITY NUMBER: 331881164
	VISIT DATE: 12/15/2025

NARRATIVE

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Interviews with clients revealed clients do have behaviors at the home and facility staff intervene as needed. Interviews with staff revealed upon incidents that required clients to go out to receive medical care, staff reports in an incident report to the Inland Regional Center (IRC) and Community Care Licensing(CCLD). Interview with IRC facility’s liaison noted not having concerns regarding the facility requirements. Document review revealed that within the last three months there has been one incident related to a hospitalization resulting from a behavior dated 12/15/25 which was send to IRC and CCLD. LPA reviewed 3 incident reports submitted to IRC and CCLD regarding client #1(C1) dated 1/3/23, 2/6/23, and 3/22/23. There were no other incident reports. The incident reports reviewed were hospitalization unrelated to behaviors.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Regarding allegation: Staff do not have appropriate training. It is alleged staff may not have training to deal with clients’ behaviors. Interviews with clients revealed staff are able to assist clients when behaviors arise. Interviews with staff revealed that staff have received training, including Crisis Prevention and Intervention (CPI) training. Per staff, when a client becomes distraught, they speak to the client to de-escalate the situation, find another interest for the client, ensure other clients do not get harm, and they contact emergency personnel only when the situation requires it. Interview with IRC facility’s liaison revealed facility administration team provides required training to staff. Per documents review, staff last received CPI training on 8/19/25.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Rosa Lopez Assistant Administrator and a copy of this report was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2025

LIC9099 (FAS) - (06/04)

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