370804788-1-31-2023-08-AS-DPOL-CNQ2YF-20230203164836

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804788
Report Date: 01/31/2023
Date Signed: 01/31/2023 04:58:13 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
01/05/2023 and conducted by Evaluator Liliana Silveira

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230105112516

FACILITY NAME:	CASA EL CAJON		FACILITY NUMBER:	370804788
ADMINISTRATOR:	REBECCA RAYO		FACILITY TYPE:	740
ADDRESS:	306 SHADY LANE		TELEPHONE:	(619) 440-1335
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY:	99	CENSUS: 94	DATE:	01/31/2023
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Administrator Rebecca Rayo		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Unlawful Eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Liliana Silveira conducted a complaint investigation visit to deliver findings for the above-mentioned allegation. LPA Silveira met with Administrator Rebecca Rayo and shared the findings.

The Department’s investigation consisted of interviews and records review. On 01/05/23 it was alleged that there was an unlawful eviction of a resident. Interviews with the Administrator and outside sources, as well as a records review, revealed that an eviction notice was provided to the resident and the resident’s responsible parties, however, the eviction notice was missing information required by Title 22 Regulations. The eviction notice did not list resources to assist resident in identifying alternative housing options as well as a statement informing residents of their right to file a complaint with CCLD. (continued on LIC 9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

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 5

Control Number 08-AS-20230105112516

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CASA EL CAJON	FACILITY NUMBER: 370804788
	VISIT DATE: 01/31/2023

NARRATIVE

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Therefore, there is sufficient evidence to determine an unlawful eviction. The preponderance of the evidence standard has been met, therefore, the above-mentioned allegation is substantiated. The violation is cited in accordance with California Code of Regulations, Title 22, and is recorded on the attached 9099-D (Deficiency) Page.

An exit interview was conducted with Administrator Rebecca Rayo, and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) was provided to Rebecca at the facility.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 08-AS-20230105112516

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CASA EL CAJON	FACILITY NUMBER: 370804788
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/10/2023 Section Cited CCR 87224(d)(1)(B)(C)	1 2 3 4 5 6 7	87224(d)(1)The notice to quit shall include the following information:(B) resources available to assist in identifying alternative housing and care options...(C) statement informing residents of their right to file a complaint with the licensing agency as specified in Section 87468. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee created a new 30 day eviction notice on 01/27/23 which includes alternative housing and care options as well as a statement informing residents of their right to file a complaint with the licensing agency. 30 day eviction notice was faxed to CCLD and Responsible parties on 01/27/23.
	8 9 10 11 12 13 14	The 30 day eviction notice did not include alternative housing and care options nor a statement informing residents of their right to file a complaint with the licensing agency.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
01/05/2023 and conducted by Evaluator Liliana Silveira

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230105112516

FACILITY NAME:	CASA EL CAJON		FACILITY NUMBER:	370804788
ADMINISTRATOR:	REBECCA RAYO		FACILITY TYPE:	740
ADDRESS:	306 SHADY LANE		TELEPHONE:	(619) 440-1335
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY:	99	CENSUS: 94	DATE:	01/31/2023
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Administrator Rebecca Rayo		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Liliana Silveira conducted a complaint investigation visit to deliver findings for the above-mentioned allegation. LPA Silveira met with Administrator Rebecca Rayo and shared the findings.

The Department’s investigation consisted of observations and interviews. On 01/05/23, it was alleged that the facility was in disrepair. It was alleged that there was mold near and inside rooms on the first floor. On 01/11/23 LPA conducted a detailed inspection of various rooms on the first floor and did not find mold. No humidity or recent water damage was observed in the facility. Interviews with maintenance staff revealed that there have been no recent floodings or large plumbing issues that could have caused water damage or subsequent mold. Interviews with outside sources and residents also revealed that there are no complaints regarding mold at the facility. (continued on 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 08-AS-20230105112516

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CASA EL CAJON	FACILITY NUMBER: 370804788
	VISIT DATE: 01/31/2023

NARRATIVE

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Due to lack of corroborating evidence, the findings regarding the above allegation were established to be unsubstantiated. This finding means that although the allegation may have happened or could be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

LPA Silveira conducted an exit interview with Rebecca. At the time of the exit interview Rebecca was provided with a copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 01-2016) and signature on this report acknowledges receipt of the rights.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Liliana Silveira	TELEPHONE: (619) 314-0756
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

LIC9099 (FAS) - (06/04)

Page: 5 of 5