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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601939
Report Date: 07/02/2024
Date Signed: 07/29/2024 12:05:00 PM

Substantiated


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
06/24/2024 and conducted by Evaluator Rebecca A Ruiz
COMPLAINT CONTROL NUMBER: 08-AS-20240624160943
FACILITY NAME:SPECIAL FRIENDS-SAGEWOODFACILITY NUMBER:
374601939
ADMINISTRATOR:WOJCIECHOWSKI, MICHELLEFACILITY TYPE:
735
ADDRESS:13411 SAGEWOOD DRIVETELEPHONE:
(858) 312-1687
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:6CENSUS: 6DATE:
07/02/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:House Manager Ramily HernandezTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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Licensee did not maintain receipts for client monies
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint visit to open an investigation and deliver findings regarding the above mentioned allegation. LPA was greeted by, identified herself to, and explained the purpose of the visit and the basic elements of the complaint with House Manager Ramily Hernandez. Administrator Michelle Wojciechowski arrived during the visit.

During today’s visit, LPA briefly toured the facility, reviewed and obtained copies of facility records, and interviewed staff and clients. LPA was away from the facility for approximately one hour between 12:00pm and 1:00pm.

The Department's investigation consisted of interviews with clients, staff, and outside sources, records review, and a tour of the facility. It was alleged that the Licensee did not maintain receipts for client monies.
Continued on LIC9099-C page.
This is an amended version of the original report dated 7/2/2024.
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
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-20240624160943
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: SPECIAL FRIENDS-SAGEWOOD
FACILITY NUMBER: 374601939
VISIT DATE: 07/02/2024
NARRATIVE
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Review of client records revealed that staff log each client’s personal and incidental (P&I) monies using the Department provided LIC405 Clients/Residents Safeguarded Cash Resources Log. Review of each client’s LIC405 revealed that the documents are kept updated and staff document each withdrawal and deposit request in separate entries. Each entry includes the date of the withdrawal or deposit, description of what the monies will be used for, the amount, the total remaining balance, and signatures by both staff and clients. Interviews with staff and clients revealed that clients would request cash from their P&I monies and staff would give the clients the requested amount and document the transaction on that specific client’s LIC405. Review of the LIC405s did not reveal any entries that were not signed by staff and clients and a review and count of each clients’ P&I monies with the Administrator during the visit did not reveal any discrepancies.

Interviews with staff revealed that clients make a majority of their purchases while supervised by staff during outings or while at the day program, however, there are a few clients who are able to access the community independently and can make purchases independently. Interviews with staff also revealed that clients will usually keep the receipt from the store and any change left over from purchases in the client’s possession. Interviews with staff revealed that most clients are able to understand the value of money, identify prices, and determine required change independently, however, two clients require staff assistance to purchase items. Interviews with staff and LPA observations revealed that the facility has a folder for each client that contains store receipts from purchases, however, clients do not always place receipts into the folder after making purchases. Review of the folder containing client receipts revealed that two of the clients are more likely to provide staff with store receipts following purchases, but the remaining clients will keep their receipts in their possession. While the facility did not have a store receipt from each client's purchase, the facility did maintain accurate records of withdrawals and deposits of each clients’ P&I monies using individual LIC405s, with required signatures acknowledging the transaction by facility staff and clients.

The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has been met, therefore, this allegation is deemed substantiated.

An exit interview was conducted with House Manager Ramily Hernandez, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).



This is an amended version of the original report dated 7/2/2024.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC9099 (FAS) - (06/04)
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