370804865-3-29-2023-08-AS-LTEZ-CQFU3T-20230331151404

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370804865
Report Date: 03/29/2023
Date Signed: 03/29/2023 02:02:30 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
01/24/2022 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20220124114040

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:	01:18 PM
MET WITH:	Bryan Myers, Administrator		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Resident has been unlawfully evicted.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced complaint visit to the facility to deliver findings for the above allegations. LPA introduced herself and disclosed the purpose of the visit to Bryan Myers, Administrator.

On 1/24/2022 it was alleged that the facility unlawfully evicted a resident by not allowing them back to the facility after a hospital visit. The Department’s investigation consisted of unannounced facility visits, review of facility records, staff interviews, outside source records and outside source interviews.

The facility was accused of not accepting a resident back from the hospital the night of 1/23/22. Facility records show that the resident was taken to the hospital on 1/20/22 and returned to the facility on 1/24/22. The facility submitted a 30-day eviction notice to the resident, responsible party, and required agencies on 1/24/22.

(Continued on LIC9099-C...)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	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-20220124114040

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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(Continued from LIC9099)

Staff interviews revealed that the facility did not refuse to allow the resident back to the facility, but facility staff were in the process of arranging the logistics of the resident’s return during the timeframe described in the complaint. Staff interview showed the facility was attempting to be in conference with discharge planning personnel and doctor to create a plan for the resident to return safely among the other residents, due to the circumstances prompting the hospitalization. Outside source interviews did not indicate that the facility stated the resident could not return. Facility records confirmed that the resident was accepted back into the facility on 1/24/22.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation(s) occurred, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with Bryan Myers, Administrator, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 01/16) were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	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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