371881361-6-20-2023-18-AS-JESL-CT8VZD-20230628165235

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 371881361
Report Date: 06/20/2023
Date Signed: 06/20/2023 04:14:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/04/2023 and conducted by Evaluator Chinwe Nwogene

COMPLAINT CONTROL NUMBER: 18-AS-20230404082311

FACILITY NAME:	QUIET HILLS LIVING		FACILITY NUMBER:	371881361
ADMINISTRATOR:	BLAKE, MARY ANN		FACILITY TYPE:	740
ADDRESS:	884 GRETNA GREEN WAY		TELEPHONE:	(760) 270-2075
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92025
CAPACITY:	6	CENSUS: 6	DATE:	06/20/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Cherry Cook, facility operator		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility staff did not provide resident adequate supervision.

INVESTIGATION FINDINGS:

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On 06/20/2023, Licensing Program Analysts (LPAs), Chinwe Nwogene and Venus Mixson conducted an unannounced visit to conclude the complaint investigation into the allegations listed above. LPAs met with facility operator, Cherry Cook who was informed of the purpose of the visit. During the investigation, staff and witnesses were interviewed.
Regarding the allegation “Facility staff did not provide resident adequate supervision”, it was alleged a resident was seen wandering on the street without supervision. LPA interviewed staff who denied resident was left wandering on the street without supervision. Witnesses were interviewed who denied seeing any resident wandering on the street without supervision.
Based on LPA’s interviews with staff and witnesses, there is not enough evidence to support the above allegation. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Cherry Cook.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Chinwe Nwogene	TELEPHONE: (951) 202-2066
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

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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