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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 371881574
Report Date: 05/22/2025
Date Signed: 05/22/2025 12:29:16 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/19/2025 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20250519150838
FACILITY NAME:LONE OAK GARDENSFACILITY NUMBER:
371881574
ADMINISTRATOR:JEAN-BAPTISTE, MICHAELFACILITY TYPE:
740
ADDRESS:712 BOZANICHTELEPHONE:
(619) 213-9545
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:6CENSUS: 3DATE:
05/22/2025
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:ADMINISTRATOR, JEAN -BAPTISTETIME COMPLETED:
12:33 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Due to lack of supervision, resident was attacked by another resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 22, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to initiate the investigation and met with Administrator, Jean- Baptiste, and explained the purpose of the visit.
During today's visit, LPA toured the facility, along with Jean Baptiste and requested and received copies of pertinent documents related to Resident #1(C1). LPA was informed that C1 does not reside at the listed facility but resides at the Independent Living (Lower Level), Room 1, which is not a part of the licensed facility.
Due to Community Care Licensing not having jurisdiction over the listed facility this allegation has been deemed "UNFOUNDED." Based on interviews, record reviews, and observations the allegation finding has been deemed "Unfounded." An allegation finding of "unfounded," means the allegation was without merit or is false and could not have happened and/or is without a reasonable basis.

There were no Health and Safety concerns observed during today's visit.
An exit interview was conducted, and a copy of this report was discussed and provided to Administrator, Jean-Baptiste.

Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
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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