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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601190
Report Date: 03/12/2024
Date Signed: 03/12/2024 01:53:44 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,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/23/2020 and conducted by Evaluator Amy Domingo
COMPLAINT CONTROL NUMBER: 08-AS-20201223153521
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: 17DATE:
03/12/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Aimee Cabling Administator TIME COMPLETED:
12:52 PM
ALLEGATION(S):
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9
Staff handled resident in a rough manner
Staff did not prevent residents from bullying another resident
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Amy Domingo, conducted an unannounced visit to the facility to conclude a complaint investigation. LPA Domingo was met at the entrance by Administrator Aimee Cabling. After identifying herself and displaying her department identification, LPA Domingo was allowed inside the facility. LPA Domingo disclosed the purpose of the visit to Licensee/Administrator Aimee Cabling

The Department’s investigation consisted of LPA observation, record reviews, and interviews with clients, staff, and outside sources.

It was alleged facility staff handled resident in a rough manner. According to interviews from Resident 1(R1) through Resident 8 (R8) (See LIC811 Confidential Names list), there were no complaints regarding staff handled resident in a rough manner. The residents that were interviewed were their own responsible party and able to make their own decisions.

[Continued on LIC9099C



Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024
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-20201223153521
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: REAL GUEST HOME OF NORTH COUNTY
FACILITY NUMBER: 374601190
VISIT DATE: 03/12/2024
NARRATIVE
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[Continued from LIC9099]

It was alleged that staff did not prevent residents from bullying another resident. Interviews with R1 through R8 did not support the allegation of staff did not prevent residents from bullying another resident. The residents that were interviewed were their own responsible party and able to make their own decisions.

Based on interviews, and direct LPA observations, a preponderance of evidence does not exist to prove that the alleged violations occurred, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted with Licensee/Administrator Aimee Cabling, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2