370802857-10-1-2025-08-AS-SMAZ-DMEMQT-20251013094913

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370802857
Report Date: 10/01/2025
Date Signed: 10/01/2025 03:08:36 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
06/23/2025 and conducted by Evaluator Arian Golbakhsh

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20250623080956

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: 66	DATE:	10/01/2025
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Office Assistant Nallely Covarrubias and Executive Director Rogelio Hernandez		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff are not ensuring resident showers.
Staff are not ensuring resident is taking medications.
Staff did not ensure facility is free of pests.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Arian Golbakhsh and Janet Ngallo conducted an unannounced visit to deliver findings regarding the above mentioned complaint allegations. LPAs were welcomed by, identified themselves to, and discussed the purpose of their visit to Office Assistant Nallely Covarrubias. Administrator Roger Hernandez arrived later during the visit. Note, LPAs did step out for lunch from 11:45-12:45.

On 6/23/25, the Department received a complaint where it was alleged that the facility was not ensuring that a resident (identified as R1) showers or takes their medications. Additionally, it was reported that there are rodents in the facility. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff, residents, and outside sources.

[Continued on LIC 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025

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 08-AS-20250623080956

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CARROLL'S COMMUNITY CARE	FACILITY NUMBER: 370802857
	VISIT DATE: 10/01/2025

NARRATIVE

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[Continued from LIC 9099]

R1 was a previous resident at the facility with a mental health diagnosis that required them to need assistance with medication management, which was provided by the facility. Per review of R1's records, R1 was noted to require assistance with medication management. Staff interviews corroborated that R1 would often refuse to take their medications. Medication refusal is within R1's rights and facilities cannot force an individual to take medications if they do not want to. Additionally, it was corroborated by staff interviews that R1, who had a history of drug use, began using again -- causing R1 to become even more noncompliant with taking their prescribed medications. Facility records also documented increased aggression and inappropriate behaviors from R1.

In regards to the allegation of the facility not ensuring R1 showered, the choice to bathe is also a Personal Right, and residents cannot be forced to bathe if they do not want to. Staff interviews corroborated that staff would provide daily reminders to residents to shower, and that R1 would choose not to, or that if R1 did bathe, they would put back on the same clothes they were wearing without washing them. Additionally, review of R1's records document that R1 did not require assistance with bathing.

In regards to the allegation of pests, staff and resident interviews corroborated that while pests have been noted at the facility, action is taken for treatment. Staff and resident interviews revealed that regular treatment by staff and outside pest control technicians are done routinely. Records review of pest control invoices and payments note monthly pest control services conducted from February 2025 through July 2025.

Based on interviews and records review, while the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred – therefore the allegations have been determined to be UNSUBSTANTIATED. An exit interview was conducted with Administrator Hernandez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025

LIC9099 (FAS) - (06/04)

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