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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370808112
Report Date: 04/24/2024
Date Signed: 04/24/2024 11:35:32 AM

Unsubstantiated


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
04/15/2024 and conducted by Evaluator Renita Hall
COMPLAINT CONTROL NUMBER: 08-AS-20240415093158
FACILITY NAME:FANCOR GUEST HOMEFACILITY NUMBER:
370808112
ADMINISTRATOR:HUERTAS, FANNIEFACILITY TYPE:
735
ADDRESS:631-651 TAFT AVENUETELEPHONE:
(619) 588-1761
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:44CENSUS: 43DATE:
04/24/2024
UNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Myra Palmer, AdministratorTIME COMPLETED:
11:35 AM
ALLEGATION(S):
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Staff spoke inappropriately to resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to open a complaint and deliver findings regarding the allegation mentioned above LPA was allowed entry by Myra Palmer, Administrator. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Administrator.

On April 15, 2024, a complaint was received alleging that staff had spoken to a resident inappropriately.
Upon receiving the complaint, an investigation was initiated.

The complainant was not able to elaborate on the allegation at the time the complaint was opened and was not available for an interview to gather additional information. However, the complainant did state in the report that Resident 1 (R1) had denied the allegation when they reported the allegation to the Department.

Continued on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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 2
Control Number 08-AS-20240415093158
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: FANCOR GUEST HOME
FACILITY NUMBER: 370808112
VISIT DATE: 04/24/2024
NARRATIVE
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The investigation included interviews with staff members, the resident, and a review of records as well as a tour of the facility.

On April 24, 2024, an interview with R1 who was allegedly spoken to inappropriately was interviewed to get their perspective on the allegation. The resident denied that any inappropriate language or tone was used by staff and is happy at the facility and that "staff are really nice to me."

Interviews with staff on April 24, 2024, and provided their version of the events. Staff 1 (S1) stated that R1 had not made statements about any staff speaking to them inappropriately. The S1 mentioned that R1 had mentioned that outside sources had made inappropriate statements to them.

Based on the interviews conducted and the review of records, it was determined that the allegation of staff speaking to the resident inappropriately is unsubstantiated. An unsubstantiated finding 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 and a copy of this report along with the Licensee Rights (LIC 9058) was provided to Myra Palmer, Administrator. Her signature on this form confirms receipt of the documents.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2