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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336424322
Report Date: 01/31/2024
Date Signed: 01/31/2024 05:07:42 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
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/05/2020 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200805151209
FACILITY NAME:D&D HOME #3FACILITY NUMBER:
336424322
ADMINISTRATOR:DOUGLAS P BEATTY IIIFACILITY TYPE:
735
ADDRESS:28769 GOLDEN DAWN DRIVETELEPHONE:
(951) 301-8572
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY:6CENSUS: 3DATE:
01/31/2024
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Douglas Beatty, Administrator TIME COMPLETED:
05:05 PM
ALLEGATION(S):
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Staff had inappropriate interactions with a resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto had administrator Beatty to discuss the elements of this complaint investigation. Meeting was conducted at the Riverside State Licensing office.

Regarding the allegation that staff had inappropriate interactions with a resident; The allegation in relation to a person not associated to the facility and this person making video calls through social media to resident #1 (R1) at the facility. R1 is deaf, but video conference caused R1 distress. Staff at the facility was aware of such communication and later consulted with R1, blocked caller from making further calls and staff self reported incident to Licensing and other outside agencies. R1 was not able to be at this time. ***continued on LIC 9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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 18-AS-20200805151209
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
RIVERSIDE, CA 92507
FACILITY NAME: D&D HOME #3
FACILITY NUMBER: 336424322
VISIT DATE: 01/31/2024
NARRATIVE
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Based on the information obtained there is not enough evidence that staff had inappropriate interactions with a resident . Therefore, the allegation is deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and administrator Beatty and copy was given to MR Beatty.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2