370804865-2-27-2023-08-AS-JRAE-CPJPTK-20230302103601

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804865
Report Date: 02/27/2023
Date Signed: 02/27/2023 02:51:51 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
11/17/2022 and conducted by Evaluator Renita Hall

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20221117161222

FACILITY NAME:	CARROLLS RESIDENTIAL CARE		FACILITY NUMBER:	370804865
ADMINISTRATOR:	BRYAN MEYERS		FACILITY TYPE:	740
ADDRESS:	655 S MOLLISON		TELEPHONE:	(619) 444-3181
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY:	144	CENSUS: 113	DATE:	02/27/2023
		UNANNOUNCED	TIME BEGAN:	02:36 PM
MET WITH:	Bryan Meyers, Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff are not addressing issue with bedbugs in the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit regarding the above-mentioned allegation. LPA were allowed entry by Director, Bryan Meyers. LPA identified herself and disclosed the purpose of the visit and elements of the complaint with

The Department investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, interviews with staff, residents, and records review, including other relevant evidence pertinent to this investigation such as Pest Control maintenance contract agreement and Inspection Reports.

On November 17, 2022 Community Care Licensing (CCL) received a complaint alleging that facility staff were not addressing issue with bed bugs in the facility. The facility has had a service contract with Orkin since 2002 for monthly pest control treatment with previous treatments November 24, 2021, December 2, 2021, and January 26, 2022, according to the February 22, 2022 invoice.
Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 767-2330
LICENSING EVALUATOR NAME: Renita Hall	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

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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Control Number 08-AS-20221117161222

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: CARROLLS RESIDENTIAL CARE	FACILITY NUMBER: 370804865
	VISIT DATE: 02/27/2023

NARRATIVE

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On February 22, 2022 service invoice indicated that the kitchen was treated and inspected for pest activity, and that pest control was to be done in the kitchen area only and the manager of the facility would take care of resident’s rooms. On November 24, 2022 LPA’s observation and bed inspections of residents revealed no remnant of bedbugs, all mattresses appeared new. Residents interviewed all stated that they did not have bedbugs at the time of visit.

On February 22, 2023 LPA conducted additional interviews with staff and residents, and tours with more residents and there were no signs of bedbugs. The Director provided additional information from Orkin that showed a list of residents’ rooms treated on February 13, 2023 for pest. The process for treatment of bedbugs is done by the Director. The Director has bought products for treatment of bedbugs. When bedbugs are discovered, removal all beds from residents’ rooms are replaced with new beds and covered with bed protectors. An interview was conducted with additional staff, who stated that there have not been any bedbugs for couple of months and beds are replaced with new beds and residents are given new sheets. This staff member also stated that residents “do their own laundry.” Residents interviewed did not have bedbugs at the time of visit.

Based on observations, interviews with residents, outside sources, and review of pertinent pest control inspection reports, there was insufficient evidence found to support the allegation that facility staff did not treat bed bug infestation. 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 with the Director. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Administrator and his signature on this report confirms receipt of the Licensee Rights.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 767-2330
LICENSING EVALUATOR NAME: Renita Hall	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

LIC9099 (FAS) - (06/04)

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