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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601895
Report Date: 01/23/2024
Date Signed: 01/23/2024 03:39:43 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
08/01/2023 and conducted by Evaluator Sabel Martinez
COMPLAINT CONTROL NUMBER: 08-AS-20230801105447
FACILITY NAME:JOY & JAY HOME CAREFACILITY NUMBER:
374601895
ADMINISTRATOR:ANA OSBORNEFACILITY TYPE:
740
ADDRESS:12946 AMARANTH STTELEPHONE:
(858) 240-7883
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY:6CENSUS: 4DATE:
01/23/2024
UNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Administrator Ana Osborne and Caregiver Melisande BauzonTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Staff hit resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced complaint investigation visit to deliver complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Melisande Bauzon. Administrator Ana Osborne arrived during the visit.

Throughout the investigation, the Department secured pertinent records and conducted interviews with external and internal sources, including staff and residents.

It was alleged that a staff member hit a resident. On 08/01/2023, it was reported to the Department a staff member had slapped a resident. Interviews with internal and external sources did not reveal any concerns with staff hitting a resident. Interviews also revealed the resident in question had described the aggressor as a white, tall, and male. Interviews along with a review of the incident report obtained from the police department, revealed the staff who had worked during the time period in question did not match the description of the suspected abuser. (See LIC 9099C for continuation of report.)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
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-20230801105447
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: JOY & JAY HOME CARE
FACILITY NUMBER: 374601895
VISIT DATE: 01/23/2024
NARRATIVE
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The responding officer interviewed and examined the resident’s facial appearance, noting no marks, no redness, and no bruises were present at the time of the interview.

Based on the evidence obtained there was not a preponderance of evidence to prove the alleged violation occurred, therefore, the allegation was unsubstantiated.

An exit interview was conducted with Caregivers Melisande Bauzon and Julius Sevilla, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
LIC9099 (FAS) - (06/04)
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