374602052-11-14-2022-08-AS-IESA-CLP57X-20221130184303

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602052
Report Date: 11/14/2022
Date Signed: 11/14/2022 03:01:53 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
03/20/2020 and conducted by Evaluator Amy Domingo

COMPLAINT CONTROL NUMBER: 08-AS-20200320101739

FACILITY NAME:	OLIVENHAIN GUEST HOME		FACILITY NUMBER:	374602052
ADMINISTRATOR:	KAREN KANAN		FACILITY TYPE:	740
ADDRESS:	350 COLE RANCH ROAD		TELEPHONE:	(760) 753-5082
CITY:	ENCINITAS	STATE: CA	ZIP CODE:	92024
CAPACITY:	0	CENSUS: 0	DATE:	11/14/2022
		UNANNOUNCED	TIME BEGAN:	03:04 PM
MET WITH:	Henry and Suzanne Kurtz former Licensee		TIME COMPLETED:	04:05 PM

ALLEGATION(S):

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Licensee failed to ensure that facility is free of rodents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Domingo sent this report to the former licensee's last known mailing address via USPS certified mail to deliver the investigation findings for the above-mentioned allegation. This facility ceased operations on September 23, 2022.

The Department’s investigation consisted of interviews with staff, outside sources, and review of records. It was alleged the Licensee failed to ensure that the facility is free of rodents. On March 30, 2020, the day the investigation was opened, Licensing Program Analyst, Denise Powell conducted an inspection and did not observe rodents inside or outside of the facility. On August 3, 2022, LPA Amy Domingo conducted a secondary inspection of the facility and did not observe rodents. On October 20, 2022, LPA Nacole Patterson visited the facility and conducted an inspection and did not observe rodents.

(Continued on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 767-2330
LICENSING EVALUATOR NAME: Amy Domingo	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022

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-20200320101739

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: OLIVENHAIN GUEST HOME	FACILITY NUMBER: 374602052
	VISIT DATE: 11/14/2022

NARRATIVE

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Interview with the pest control company representative that provides services to the facility revealed that they have no record of the facility having a rodent infestation specially for the month in question, March 2020. The pest control company representative confirmed they continue to provide monthly services with no break in service to date. The representative’s statements were corroborated by a review of the monthly service invoices provided to the Department for the months of March and April of 2020.

Interview with staff and administrator revealed that they have not experienced a rodent infestation and the facility has taken precautionary measures to prevent an infestation of pests. The Department attempted interviews with other staff and outside sources to no avail.

The Department has investigated the above allegation. Based on evidence obtained, including interviews and records reviewed, the allegation is determined as unsubstantiated as the Department could not meet the preponderance of the evidence standard.

A copy of this report and Licensee/Appeals Rights (LIC 9058) were sent to the licensee's last known address via USPS certified mail due to facility closure.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 767-2330
LICENSING EVALUATOR NAME: Amy Domingo	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2022

LIC9099 (FAS) - (06/04)

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