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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370802857
Report Date: 02/23/2026
Date Signed: 02/24/2026 08:47:51 PM

Substantiated


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
03/23/2023 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 08-AS-20230323103934
FACILITY NAME:CARROLL'S COMMUNITY CAREFACILITY NUMBER:
370802857
ADMINISTRATOR:ROGELIO HERNANDEZFACILITY TYPE:
735
ADDRESS:523 EMERALD AVENUETELEPHONE:
(619) 442-8893
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:70CENSUS: 68DATE:
02/23/2026
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Administrator Rogelio HernandezTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility did not follow Absentee Notification Plan
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today to deliver findings on the allegations listed above. LPA met with Rogelio Hernandez and explained the purpose of today's visit.

Regarding the allegation facility did not follow Absentee Notification Plan. Records indicate the facility had not developed or implemented an Absentee Notification Plan for Resident 1, as required. The Administrator stated he attempted to contact Telecare Gateway on 03/13/2023 to notify them the Resident 1 had not returned, but this was not confirmed, and Telecare Gateway staff later reported they were not informed when they visited the facility on 03/14 and 03/15. Telecare Gateway was not made aware of the resident’s absence or death until 03/17/2023. Additionally, the Administrator did not notify local law enforcement when the resident was missing, stating it was Telecare Gateway’s responsibility. The Administrator acknowledged the resident had been absent for over 24 hours without reporting. Based on this information, there is sufficient evidence to determine the facility failed to comply with absentee notification requirements. Based on interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.


The following deficiencies are being cited (see LIC 9099D) from the California Code of Regulations, Title 22, and California Health and Safety Code. This incident is currently under review and a future civil penalty may apply based on 1569.49(f) H&S. Failure to correct the deficiencies may also result in civil penalties. Exit interview conducted with facility Administrator Rogelio Hernandez, and appeal rights provided.






Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
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 3
Control Number 08-AS-20230323103934
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
02/24/2026
Section Cited
HSC
1507.15
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Title 22, Division 6
Health and Safety Code
Chapter 03 California Community Care Facilities Act
Article 01. General Provisions
§1507.15 Every community care facility that provides adult residential care or offers an adult day program shall, for the purpose of addressing issues that arise when an adult resident or an adult day program participant is missing from the facility, develop and comply with an absentee notification plan for each resident or participant. The plan shall be part of the written Needs and Services Plan. The plan shall include and be limited to the following: a requirement that an administrator of the facility, or his or her designee, inform the resident’s or participant’s authorized representative when that resident or participant is missing from the facility and the circumstances in which an administrator of the facility, or his or her designee, shall notify local law enforcement when a resident or participant is missing from the facility.
The following requirement has not been met as evidenced by:
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Facility Administrator will ensure all direct care staff and administrators will receive retraining on: the facility’s Absentee Notification Plan,Required notification timelines pursuant to Health & Safety Code §1507.15, and documentation requirements when a resident is missing, and send proof to LPA by POC date of 02/24/2026.
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The proper procedure was not implented after Resident 1 did not return to the facility on 03/13/2025, which poses an immediate health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
03/23/2023 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 08-AS-20230323103934

FACILITY NAME:CARROLL'S COMMUNITY CAREFACILITY NUMBER:
370802857
ADMINISTRATOR:ROGELIO HERNANDEZFACILITY TYPE:
735
ADDRESS:523 EMERALD AVENUETELEPHONE:
(619) 442-8893
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:70CENSUS: 68DATE:
02/23/2026
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Administrator Rogelio HernandezTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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9
Questionable death
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced visit today to deliver findings on the allegations listed above. LPA met with Rogelio Hernandez and explained the purpose of today's visit.

Regarding the allegation questionable death. On 03/12/2023, facility Administrator observed Resident 1 leaving the facility with a black bag. The resident did not return on 03/13/2023. On 03/15/2023, facility Administrator received a call from the resident’s mother reporting that Resident 1 had been involved in a hit-and-run accident on 03/13/2023 and passed away on 03/14/2023. Although the complaint alleged the resident’s death was due to neglect or lack of supervision, the information reviewed does not support that the facility’s actions caused or contributed to the resident’s passing. The resident had voluntarily left the facility and was in the community when the incident occurred. There is insufficient evidence to establish that the death would have been prevented had the facility acted differently. Based on interviews conducted, documentation obtained, and medical records reviewed, this allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

The following deficiencies are being cited Per Title 22 Regulations. Exit interview conducted with Administrator Rogelio Hernandez, and a copy of this report, along with appeals rights provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3