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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336411349
Report Date: 07/11/2023
Date Signed: 07/11/2023 02:31:48 PM

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
12/08/2021 and conducted by Evaluator Amy Goldenberg
COMPLAINT CONTROL NUMBER: 18-AS-20211208141931
FACILITY NAME:BENSON HOUSE #7FACILITY NUMBER:
336411349
ADMINISTRATOR:ORALIA WILLIAMSFACILITY TYPE:
735
ADDRESS:910 RIVER DRIVETELEPHONE:
(951) 279-0366
CITY:NORCOSTATE: CAZIP CODE:
92860
CAPACITY:4CENSUS: 3DATE:
07/11/2023
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Jasmine Gonzalez, ManagerTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared adult present in the home.
Staff members are arguing with visitors in the presence of residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This unannounced visit by Amy Goldenberg, Licensing Program Analyst (LPA), is being conducted to conclude this agency’s investigation into the complaint allegations mentioned above. During the course of this investigation LPA conducted interviews of consumers, conducted interviews with staff, and reviewed surveillance video from 12/06/2021. It is alleged that S1 had a visitor and that S1 was arguing with their visitor in front of the residents. Review of the surveillance does not show the individual entering the home. Video shows S1's visitor at the door and S1 and their visitor walking down the driveway of the property. Based on review of surveillance video and inconsistencies of information received through interviews of staff and consumers there is no evidence to support or refute the alleged allegation of anyone without a fingerprint clearance being allowed in the home or if staff member was arguing with visitors in the presence of residents. We have found the complaint allegation is unsubstantiated, although the allegation may have happened or is valid: there is not a preponderance of the evidence to prove that the alleged violation occurred. A copy of this report is being reviewed with and furnished to the facility representative
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amy Goldenberg
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
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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