<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600546
Report Date: 08/11/2023
Date Signed: 08/13/2023 09:50:26 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
06/19/2023 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20230619135003
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: 7DATE:
08/11/2023
UNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Caregiver Julita RenojoTIME COMPLETED:
05:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not protecting the residents in care.
Staff made an inappropriate comment towards resident.
Staff yelled at resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Correia conducted an unannounced visit to deliver investigative findings on the above-mentioned allegations. LPA identified herself and discussed the purpose of the visit with Caregiver Renojo.

The Department’s investigation consisted of client, staff interviews, and outside source interviews.

It was alleged the facility is not protecting the residents in care. An interview conducted with Client 1 (C1) revealed another Client 2 (C2) that resided at the facility would come to the facility intoxicated and would antagonize C1. C1 also revealed C2's drinking issue was a triggering behavior and felt staff did not do anything to protect the clients in care from C2 provoking a hostile environment. Interviews with other clients in care revealed no issues at the facility, regarding C2 or any of the other clients. Interviews conducted with clients also revealed they had never encountered or witness staff yell or make inappropriate comments toward clients. Additional interviews with facility staff and an outside source revealed C1 was being relocated due to needing a higher lever of care, as well as their disruptive behavior.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
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-20230619135003
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: 08/11/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Due to lack of corroborating evidence, the finding regarding the above allegations were established to be unsubstantiated. This finding means although the allegations may have happened or could be valid, but there is not a preponderance of evidence to prove that the alleged violations occurred.

LPA conducted an exit interview with Caregiver Renojo. At the time of the exit interview Caregiver Renojo was provided a copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 01-2016) and signature on this report acknowledges receipt of the documents.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2