374601276-7-30-2024-08-AS-JLOT-D8CUA9-20240821152421

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374601276
Report Date: 07/30/2024
Date Signed: 07/30/2024 01:47:21 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
07/22/2024 and conducted by Evaluator Carmen Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20240722145317

FACILITY NAME:	ANGEL'S GUEST HOME #1		FACILITY NUMBER:	374601276
ADMINISTRATOR:	JENKINS, PATRICIA		FACILITY TYPE:	740
ADDRESS:	9208 BELLAGIO RD		TELEPHONE:	(619) 258-2013
CITY:	SANTEE	STATE: CA	ZIP CODE:	92071
CAPACITY:	6	CENSUS: 5	DATE:	07/30/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Cathy Mcevoy, Licensee		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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- Staff did not ensure facility was free from pests

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to open a complaint investigation. While at the facility LPA investigated and delivered findings regarding the above-mentioned allegation. LPA identified herself and was granted entry by Zlota Levine, caregiver. LPA stated the purpose of the visit and reviewed the findings of the complaint with caregiver Levine and Licensee Cathy Mcevoy who later arrived and joined the visit.

The Department’s investigation consisted of interviews with staff, review of pertinent records, and LPA observations of the facility grounds. On July 22, 2024, it was alleged that staff did not ensure that the facility was free from pests.

It was specifically alleged that the facility had cockroaches and fleas throughout the facility. Interview with staff said they are aware that the facility owner does have a pest control company come out every so often to render services. Staff mentioned that they have also bathed the dogs.
(Continuation on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) -34-3976
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20240722145317

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ANGEL'S GUEST HOME #1	FACILITY NUMBER: 374601276
	VISIT DATE: 07/30/2024

NARRATIVE

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(Continuation of LIC9099)

Per the Licensee, they do have a pest control company come out to the facility bi-monthly to treat for cockroaches and fleas. Licensee did mention that a staff saw a flea on one of their dogs and they immediately addressed the issue with resident families and on their own facility cat and dog. Per the licensee, all the pets were treated within one week of the notifications of the fleas. The pest control company’s notice shows they do render services for pests which includes fleas and cockroaches. Licensee said that they have contacted their pest control company to schedule another appointment for August 1, 2024. Per staff and the Licensee, all their facility pets have received treatments for fleas. A review of records revealed that the facility does have a pest control company that renders services to the facility bi-monthly. Invoices show that they have recently had their pest control company come out to treat the facility on July 1, 2024. The facility provided a former invoice for May 2024 for pest control services rendered. The facility provided invoices for three of the four pets that received treatment from Veterinary Hospitals. The fourth pet did have a home treatment placed on them which staff provided the oral and topical treatments they have been dispensing to that pet. The invoices for the Veterinary Hospitals showed that they treated their pets for fleas and ticks. On July 30, 2024, LPA toured the facility and observed that there were only dead cockroaches on trappings located between the refrigerator and a countertop, and under the kitchen sink where only vases are kept. LPA did not observe any cockroaches that were alive anywhere throughout the facility. LPA inspected each of the resident’s rooms, bathrooms, dining room, living room, garage, outside patio area, pond area, and both sides of the facility. The facility was clean and sanitary, but only needed to clean the area(s) where the trappings were located which staff cleaned while LPA was at the facility. All pet supplies were organized in their designated area’s. LPA did not observe the pets scratching themselves for fleas while at the facility.

Based on the Department’s investigation of the above-mentioned allegation and the evidence obtained during staff interviews, records reviewed, and LPA observations, there is insufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegation is deemed to be unsubstantiated.

The report was discussed, and an exit interview was conducted with Licensee Cathy Mcevoy. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to Licensee Mcevoy at the conclusion of the visit. The signature below confirms the receipt of these documents.

SUPERVISOR'S NAME: Jennifer Lott	TELEPHONE: (619) -34-3976
LICENSING EVALUATOR NAME: Carmen Lopez	TELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

LIC9099 (FAS) - (06/04)

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