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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601232
Report Date: 10/28/2022
Date Signed: 10/28/2022 03:19:31 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
07/28/2022 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20220728092437
FACILITY NAME:JOY'S HOMECAREFACILITY NUMBER:
374601232
ADMINISTRATOR:LIGAYA SANDERSFACILITY TYPE:
735
ADDRESS:1406 I AVENUETELEPHONE:
(619) 474-0198
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:6CENSUS: 6DATE:
10/28/2022
UNANNOUNCEDTIME BEGAN:
11:12 AM
MET WITH:Agnus V, Ebidag, CaregiverTIME COMPLETED:
11:53 AM
ALLEGATION(S):
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Staff bullies resident
Staff did not ensure the facility was free from pests
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to deliver findings on the above-mentioned allegations. LPA gained access to the facility, identified herself, and met with Agnus V, Ebidag, Caregiverto discuss the purpose of the visit.

LPA visit consisted of delivering findings on the above-mentioned allegations.

LPA conducted the initial investigation visit on August 4 2022, and was able to interview clients, facility staff, and outside sources. LPA also reviewed records and conducted a physical inspection of the facility. It was alleged that staff bullies residents. Interviews revealed that the staff treat the clients kind and are respectful to them. Interviews revealed that the staff are helpful and they assist the clients with meals and cleaning.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022
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-20220728092437
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: JOY'S HOMECARE
FACILITY NUMBER: 374601232
VISIT DATE: 10/28/2022
NARRATIVE
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Interviews with staff denied the allegations of staff bullying the residents. Interviews revealed the staff don't even let the clients bully each other. Interviews revealed the staff know they cannot violate the personal rights of the clients.

It was alleged that staff did not ensure the facility was free from pests. Interviews revealed there were pests at the facility and that the facility sprayed and laid down bug traps. Interviews revealed since the facility has been spraying there hasn't been any pests around the facility. Interviews revealed once the clients advised the staff that there was small pests the administrator picked up the hot shot spray and pest houses.

The investigation did not produce supporting evidence to prove that the staff bullies residents and staff did not ensure the facility was free from pests.

Based on the evidence obtained from interviews, and LPA observation, the complaint allegations are found to be unsubstantiated; as there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted with Agnus V, Ebidag, Caregiver and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) was provided at the conclusion of the visit

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2