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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601767
Report Date: 02/13/2025
Date Signed: 02/14/2025 05:41:19 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
02/07/2025 and conducted by Evaluator Liliana Silveira
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20250207103559
FACILITY NAME:BROAS GUEST HOMEFACILITY NUMBER:
374601767
ADMINISTRATOR:ALBERTO BROASFACILITY TYPE:
735
ADDRESS:2231 FOWLER DRIVETELEPHONE:
(619) 470-6644
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:15CENSUS: 14DATE:
02/13/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Caregivers Lani Custodio and Victoria GuiwoTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Licensee did not ensure faucets for personal care deliver hot water.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced complaint investigation visit. LPA Silveira introduced themselves, met with Cook/Caregiver Lani Custodio and disclosed the purpose of the visit. Cook/caregiver Victoria Guiwo arrived shortly after. The purpose of the visit was to conduct a complaint investigation and to deliver complaint findings for the above-mentioned allegation.

The Department’s investigation consisted of LPA observations, client and staff interviews. On 02/07/25 it was alleged that the Licensee did not ensure that sink faucets for personal care delivered hot water. It was alleged that clients had been without hot water for four (4) days. Department interviews conducted with the Licensee and three (3) facility staff revealed that hot water was not available for approximately 5 days due to the water heater breaking down. Interviews with staff and the Licensee also revealed that two different parts had to be ordered to fix the water heater, creating a delay. The hot water returned on approximately 02/10/25. (CONTINUED ON NEXT PAGE, LIC 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
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-20250207103559
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: BROAS GUEST HOME
FACILITY NUMBER: 374601767
VISIT DATE: 02/13/2025
NARRATIVE
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(CONTINUED FROM FIRST PAGE, LIC 9099)
Interviews with three (3) clients revealed that while the water heater was broken and hot water was unavailable, clients were informed of the problem and were provided with the option to have water heated over the stove for showers. Interviews with the clients and staff also revealed that this is not a re-occurring problem. Observations from a facility visit conducted on 02/13/25 revealed that the bathroom faucets used by clients had hot water. The kitchen faucet also had hot water.

The Department was unable to interview the Reporting Party (RP) due to the RP not being available when contacted.

Due to a lack of corroborating evidence, the allegation that the Licensee did not ensure that faucets for personal care delivered hot water is unsubstantiated. Although the allegation may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation occurred, therefore, the allegation is unsubstantiated.

LPA Silveira conducted an exit interview with Victoria Guiwo. a copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 03/22) were provided. The signature on this report acknowledges receipt of the documents.
SUPERVISORS NAME: Robyn Clark
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2