370802857-12-12-2023-08-AS-DPOL-CYQP3G-20231221095731

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370802857
Report Date: 12/12/2023
Date Signed: 12/12/2023 01:08:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/28/2023 and conducted by Evaluator Renita Hall

COMPLAINT CONTROL NUMBER: 08-AS-20230928083817

FACILITY NAME:	CARROLL'S COMMUNITY CARE		FACILITY NUMBER:	370802857
ADMINISTRATOR:	ROGELIO HERNANDEZ		FACILITY TYPE:	735
ADDRESS:	523 EMERALD AVENUE		TELEPHONE:	(619) 442-8893
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY:	70	CENSUS: 60	DATE:	12/12/2023
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Stephanie Ortega, Med/Tech		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff yelled at client

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to deliver findings regarding the above-mentioned allegation LPA was allowed entry by Stephanie Ortega, Med/Tech. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Med/Tech.

On September 28, 2023, it was alleged that a staff member at Carroll's Community Care yelled at a client while getting medication. This investigation aimed to determine the veracity of the claim and establish whether any staff misconduct occurred. On October 4, 2023, staff and residents were interviewed regarding the alleged incident. No one witnessed staff raising their voice or yelling at any residents.

There was insufficient evidence found to support the allegation that the staff yelled at the client. Due to a lack of evidence, the allegation is deemed to be unsubstantiated. A finding that is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.An exit interview was conducted and a copy of this report along with the Licensee Rights (LIC 9058) was provided to Stephanie Ortega, Med/Tech. Her signature on this form confirms receipt of the documents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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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