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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601190
Report Date: 01/06/2023
Date Signed: 01/06/2023 12:25:15 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, 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
09/22/2022 and conducted by Evaluator Tricia Danielson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20220922142317
FACILITY NAME:REAL GUEST HOME OF NORTH COUNTYFACILITY NUMBER:
374601190
ADMINISTRATOR:AIMEE CABILINGFACILITY TYPE:
735
ADDRESS:1225 E. PENNSYLVANIA AVENUETELEPHONE:
(760) 291-1349
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:49CENSUS: 16DATE:
01/06/2023
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Aimee Cabiling, Licensee/AdministratorTIME COMPLETED:
12:35 PM
ALLEGATION(S):
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Resident's personal rights are violated
INVESTIGATION FINDINGS:
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Licensing Program Analyst(LPA) Tricia Danielson arrived unannounced to the facility to conclude a complaint investigation into the allegations listed above. LPA met with Licensee/Administrator(LIC/AD) Aimee Cabiling and explained the purpose of the visit.
Regarding the allegation "Resident's personal rights are violated", it was alleged that facility residents have been prohibited by the licensee from communicating with former Resident #1(R1) and are also threatened with eviction if they speak with licensing staff/investigators. LPA conducted interviews with eight(8) residents. Seven(7) of Eight(8) residents reported being encouraged by LIC/AD Cabiling to refrain from speaking with R1. One(1) of eight(8) residents interviewed reported they had been threatened with eviction if they spoke to licensing staff/investigators, and one(1) of eight(8) residents reported they had been threatened with being sued if they reported bed bugs in the facility to licensing.
Based on LPA’s interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099 D.
An exit interview was conducted and a copy of this report was provided along with Appeal Rights.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Tricia Danielson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
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 3
Control Number 18-AS-20220922142317
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: REAL GUEST HOME OF NORTH COUNTY
FACILITY NUMBER: 374601190
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/03/2023
Section Cited
CCR
80072(a)(1)
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Personal Rights- (a)...each client shall have personal rights which include, but are not limited to, the following:(1)To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:
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Licensee agrees to submit a written statement of understanding of the regulation cited and the importance of maintaining resident's personal rights. Proof of POC to be submitted by 1/13/2023.
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The licensee did not maintain facility resident's personal rights. Based on interviews conducted, 7 of 12 residents indicated the licensee encouraged residents to refrain form speaking with former R1. This poses a potential health, safety, and personal rights risks to residents 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: Deborah Mullen
LICENSING EVALUATOR NAME: Tricia Danielson
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3