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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600546
Report Date: 07/06/2023
Date Signed: 07/06/2023 08:00:28 PM

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
07/03/2023 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20230703132308
FACILITY NAME:CAL-CRIS LODGEFACILITY NUMBER:
374600546
ADMINISTRATOR:GLADYS BELTRANFACILITY TYPE:
735
ADDRESS:8944 EMERALD GROVE AVENUETELEPHONE:
(619) 390-8501
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:10CENSUS: 9DATE:
07/06/2023
UNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Caregiver Julita RenojoTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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9
Staff not cleaning facility restroom(s).
INVESTIGATION FINDINGS:
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Analyst (LPA) Correia conducted an unannounced visit to commence and 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.

It was alleged facility staff were not cleaning the facility restroom(s). An Interview conducted Staff 1 (S1) revealed they and Staff 2 (S2) both clean the facility, however there are three (3) clients who consistently volunteer and help clean as well. Interviews conducted with clients in care all corroborated facility staff are constantly cleaning, and those clients identified as volunteering all confirmed they enjoy helping staff by cleaning the facility. LPA confirmed they are not assigned cleaning assignments at the facility and any of the cleaning conducted by clients in care is voluntary.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023
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 2
Control Number 08-AS-20230703132308
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: 07/06/2023
NARRATIVE
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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 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: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2