370808527-4-28-2025-08-AS-APAO-DJP6JE-20250717205101

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 370808527
Report Date: 04/28/2025
Date Signed: 04/28/2025 12:38:08 PM

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
04/24/2024 and conducted by Evaluator Renita Hall

COMPLAINT CONTROL NUMBER: 08-AS-20240424102740

FACILITY NAME:	NOAH HOMES, INC.		FACILITY NUMBER:	370808527
ADMINISTRATOR:	SANDRA ROCCO-MELVILLE		FACILITY TYPE:	735
ADDRESS:	12526 CAMPO ROAD		TELEPHONE:	(619) 660-6200
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91978
CAPACITY:	78	CENSUS: 78	DATE:	04/28/2025
		UNANNOUNCED	TIME BEGAN:	12:36 PM
MET WITH:	Valerie Davis, Program Coordinator		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff does not ensure reporting requirements are followed
Staff does not ensure clients are provided adequate care supervision
Staff abandoned client during an outing
Staff left client alone in a parked vehicle
Staff allowed client to be left in soiled clothing for extended period of time
Staff did not seek medical attention for client in a timely manner
Staff does not ensure client records are properly maintained
Staff does not ensure medications are dispensed as prescribed

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to deliver findings regarding the above-mentioned allegations LPA was allowed entry by , the Director. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Director.

On March 24, 2024, the Department received a complaint regarding the following allegations against the staff at Noah Homes Inc. The specific allegations are as follows: staff does not ensure reporting requirements are followed, staff does not ensure clients are provided adequate care supervision, staff abandoned a client during an outing, staff left a client alone in a parked vehicle, staff allowed a client to be left in soiled clothing for an extended period, staff does not ensure medications are dispensed as prescribed, staff did not seek medical attention for a client promptly, and staff does not ensure client records are properly maintained.

Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

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-20240424102740

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: NOAH HOMES, INC.	FACILITY NUMBER: 370808527
	VISIT DATE: 04/28/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The investigation process included interviews with staff members, reviewing facility records, interviews with residents, and a tour of the facility. Reviewing reporting protocols and records indicated that all required reports were completed and submitted on time. Interviews with administrative staff confirmed adherence to reporting requirements. Observations and staff interviews revealed that clients received appropriate supervision. Care logs and schedules show that staff-to-client ratios meet standards. The staff interviewed did not know about the abandonment of residents on outings.

Care logs and direct observations showed that clients are regularly checked and changed as needed. A review of medication administration records were dispensed accurately and as prescribed. No discrepancies were found. Medical logs were reviewed, and no errors were found. No instances of delay were identified. A review of client records indicated that all records are up-to-date and properly maintained. Staff interviews confirmed adherence to record-keeping protocols. The resident in question, with regards to being left in soiled clothing for an extended period, has been diagnosed with GERD and can advocate for themselves.

The investigation concluded that all allegations against the staff were unsubstantiated. The facility's records, staff interviews, and direct observations indicate that the staff were performing their duties according to the required standards and protocols. 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 Valerie Davis, Program Coordinator. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Program Coorindator, and her signature on this report confirms receipt of the Licensee Rights.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2