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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600188
Report Date: 01/10/2023
Date Signed: 01/10/2023 01:47:01 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/30/2022 and conducted by Evaluator Elizabeth Hamilton
COMPLAINT CONTROL NUMBER: 08-AS-20221230161549
FACILITY NAME:AQUINO'S QUALITY HOMECAREFACILITY NUMBER:
374600188
ADMINISTRATOR:FELICIDAD M. AQUINOFACILITY TYPE:
735
ADDRESS:598 IVY COURTTELEPHONE:
(619) 482-6897
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY:6CENSUS: 5DATE:
01/10/2023
UNANNOUNCEDTIME BEGAN:
12:08 PM
MET WITH:Caregiver, Eufrosina Hernandez and Licensee, Bernardo AquinoTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility was not sanitary
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced complaint investigation at the facility for the above allegation. LPA was greeted at the front entrance by Caregiver, Eufrosina Hernandez, identified herself and was granted entry into the facility. Licensee Bernardo Aquino arrived during the visit. LPA Hamilton explained the purpose of the visit and the elements of the complaint.

The investigation consisted of client records requested and reviewed, interviewed staff and outside sources and a brief tour the facility.

On December 30, 2022, it was alleged that the facility was not sanitary in a client shared bathroom. Outside sources corroborated the private bathroom used by client 1 (C1) and client 2 (C2) was unclean with yellow staining, rust and unknown black markings on the floor. On January 10, 2023, LPA observed the shared bathroom in question and confirmed it to be unsanitary with dirt and grime staining on the shower tiles and black dirt on the shower and bathroom floor. Interviews with staff 1 (S1) confirmed the bathroom did have staining.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023
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 3
Control Number 08-AS-20221230161549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: AQUINO'S QUALITY HOMECARE
FACILITY NUMBER: 374600188
VISIT DATE: 01/10/2023
NARRATIVE
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The Department has investigated the allegation of facility was not sanitary. Based on evidence obtained, the allegation is substantiated which means that the allegation is valid because the preponderance of the evidence standard has been met. A deficiency is cited in accordance of California Code of Regulations, Title 22, Division 6 Chapter 8, and listed on the 9099D.

An exit interview was conducted with Licensee, Bernardo Aquino a copy of this report, LIC 9099D and Licensee/Appeals Rights (LIC 9058 01/16) was provided.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20221230161549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: AQUINO'S QUALITY HOMECARE
FACILITY NUMBER: 374600188
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/07/2023
Section Cited
CCR
8088
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8088 Furniture, Fixtures, Equipment, and Supplies (e) (3) All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating condition. This requirement was not met as evidenced by:
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Licensee stated they will hire a cleaning company to deep clean the bathroom and will create a daily cleaning log at the facility. Licensee will provide a picture of the grime and dirt removed from the bathroom shower and floor and a replaced shower curtain, and a copy of the daily cleaning log to the Department by 02/07/2023.
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Based on interviews and LPA observations, the licensee did not ensure that the clients in care were not provided sanitary accommodations. This posed a potential health risk to 2 of 5 clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3