374600546-6-25-2023-08-AS-SJAB-CT7L2A-20230627082202

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600546
Report Date: 06/24/2023
Date Signed: 06/25/2023 09:26:54 AM

Unsubstantiated

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
05/05/2023 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20230505170754

FACILITY NAME:	CAL-CRIS LODGE		FACILITY NUMBER:	374600546
ADMINISTRATOR:	GLADYS BELTRAN		FACILITY TYPE:	735
ADDRESS:	8944 EMERALD GROVE AVENUE		TELEPHONE:	(619) 390-8501
CITY:	LAKESIDE	STATE: CA	ZIP CODE:	92040
CAPACITY:	10	CENSUS: 9	DATE:	06/24/2023
		UNANNOUNCED	TIME BEGAN:	03:58 PM
MET WITH:	Caregiver Julita Renojo		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility is not providing a safe environment for residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Correia conducted an unannounced visit to deliver investigative findings on the above-mentioned allegation. LPA identified herself and discussed the purpose of the visit to .
Caregiver Renojo.

The Department’s investigation consisted of client and staff interviews. The investigation also consisted of a facility and resident record review, LPA observations, and a tour of the facility.

It was alleged the facility is not providing a safe environment for clients in care. An interview conducted revealed Client1 (C1) was causing daily issues and chaos at the facility due to C1’s chronic drinking and being inebriated. The interview revealed C1 would go on racial rants and would vomit all over the facility, leaving other clients to clean. A review of C1’s records revealed C1 was dual diagnosed including a diagnosis of alcoholism. Further review of C1’s records revealed, as of January of 2022, C1 was active in a recovery program, and as May of 2022, C1 records revealed they received WRAP services, which included other support groups. The resident record review did not reveal any documents regarding C1’s conditions that were more current than May 2022. Interviews conducted with clients in care, including C1’s roommate, and facility staff corroborated that there weren’t any issues at the facility, including any issues between clients, or client issues involving alcohol or substance abuse. Interviews also revealed clients got along well, besides a few small arguments in the past that were resolved without issue, and that clients in care were calm.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2023

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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Control Number 08-AS-20230505170754

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: CAL-CRIS LODGE	FACILITY NUMBER: 374600546
	VISIT DATE: 06/24/2023

NARRATIVE

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LPA conducted a facility tour while clients were present, clients were observed co-mingling and watching television. LPA briefly spoke to C1, who declined to be interviewed, however was observed to be oriented, alert, and had a pleasant demeanor.

Due to lack of corroborating evidence, the finding regarding the above allegation was established to be unsubstantiated. This finding means although the allegation may have happened or could be valid, but there is not a preponderance of evidence to prove that the alleged violation occurred.

LPA conducted an exit interview with Caregiver Renojo. At the time of the exit interview Caregiver Renojo was advised a copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 01-2016) will be provided and signature on this report acknowledges receipt of the documents.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2023

LIC9099 (FAS) - (06/04)

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