370804865-3-29-2023-08-AS-JRAE-CQEU75-20230330151922

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804865
Report Date: 03/29/2023
Date Signed: 03/29/2023 12:22:51 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
03/09/2023 and conducted by Evaluator Renita Hall

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230309134942

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: 116	DATE:	03/29/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Bryan Meyers, Director Sarita Mendez, Office Assistant		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Facility staff did not keep resident’s room free from pests.
Facility staff did not treat resident with dignity.

INVESTIGATION FINDINGS:

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

The Department investigated the above listed complaint allegations. 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 March 9, 2023 Community Care Licensing (CCL) received a complaint alleging that facility staff did not keep resident's room free from pests; and facility staff did not treat resident with dignity. The facility has had a service contract with Orkin since 2002 for monthly pest control treatment with previous treatments February 13, 2023, January 14, 2023, and December 14, 2022 according to the March 13, 2023 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: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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-20230309134942

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: 03/29/2023

NARRATIVE

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As of March 13, 2023, Orkin Pest control provided services to several residents’ rooms that included crack and crevice preventative maintenance to prevent bed bug and German roach activity. A hole in the wall was observed in the kitchen area by the Orkin technician and sealed hole in the wall to prevent rats from entering. On March 16, 2023 LPA’s observation; bed inspections, and room inspection revealed no remnant of bedbugs or other pests, all mattresses appeared new. Residents interviewed all stated that they did not have bedbugs or other pest at the time of visit.

The Director provided service invoice from Orkin that showed a list of residents’ rooms treated on March 13, 2023 for pest. 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. Residents' personal belongings are treated with non-toxic chemicals and returned to resident.

LPA interviewed residents with regards to treatment by facility staff to residents. All residents interviewed had no complaints with how they were being treated by staff and have not witnessed any improper behavior by staff and seemed to be pleased with their stay at the facility.

LPA interviewed staff and has not witnessed or received any complaints of staff not treating resident’s with dignity.

Based on observations, interviews with residents, outside sources, and review of pertinent pest control inspection reports, there was insufficient evidence found to support the allegations that facility staff did not keep resident's room free from pests; and did not treat resident with dignity. Due to a lack of evidence, the allegations are deemed to be unsubstantiated. A finding that is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with the Office Assistant. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Office Assistant and her 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: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC9099 (FAS) - (06/04)

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