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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880707
Report Date: 10/11/2023
Date Signed: 10/11/2023 10:51:32 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
09/25/2023 and conducted by Evaluator Anna Bueno
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20230925084719
FACILITY NAME:WINDROSE HOUSE, THEFACILITY NUMBER:
361880707
ADMINISTRATOR:ELIZABETH GONZALEZFACILITY TYPE:
735
ADDRESS:7411 WINDROSE DRTELEPHONE:
(909) 280-3285
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:4CENSUS: 3DATE:
10/11/2023
UNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Crystal Guzman, DSPTIME COMPLETED:
10:54 AM
ALLEGATION(S):
1
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9
Staff handled resident in a rough manner.
Staff spoke to resident in an inappropriate manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Bueno conducted a subsequent unannounced visit to the facility to continue the investigation the above mentioned complaint allegations and deliver findings. LPA identified herself to direct support staff (DSP) Crystal Guzman who was informed of the reason for today’s visit. The investigation included staff interviews, facility inspection, and records review. The Department was not able to interview Client 1 (C1).

The allegations are Staff handled resident in a rough manner and Staff spoke to resident in an inappropriate manner. Interview with Witness 1 (W1) stated that C1 has a history of making false accusations but that W1 has not observed concerning behavior from any facility staff. Client interviews deny inappropriate interactions with any staff. Interview with Staff 1 (S1) stated that they have never placed their hands on or used inappropriate language with C1. Interviews with S1 and Staff 2 (S2) confirm that C1 has made accusations of S1 physically abusing C1 in the past but were not true. Interviews with W1, S1, and S2 stated that law enforcement investigated the allegations however no reports were filed. Records reviewed reveal that C1 makes false allegations. Based on the above information, the allegations are therefore UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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-20230925084719
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: WINDROSE HOUSE, THE
FACILITY NUMBER: 361880707
VISIT DATE: 10/11/2023
NARRATIVE
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A finding of unsubstantiated means although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted with Crystal Guzman and a copy of this report was provided.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2