374602093-4-27-2025-18-AS-RORN-DGAMJC-20250502093856

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602093
Report Date: 04/27/2025
Date Signed: 04/27/2025 09:16:27 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/26/2024 and conducted by Evaluator Deborah Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240226162230

FACILITY NAME:	ALTA II		FACILITY NUMBER:	374602093
ADMINISTRATOR:	CHRISTINA GRUBBS		FACILITY TYPE:	735
ADDRESS:	1337 ALTA VISTA DRIVE		TELEPHONE:	(760) 941-0919
CITY:	VISTA	STATE: CA	ZIP CODE:	92084
CAPACITY:	6	CENSUS: 5	DATE:	04/27/2025
		UNANNOUNCED	TIME BEGAN:	08:11 AM
MET WITH:	Zoe Wilson		TIME COMPLETED:	09:11 AM

ALLEGATION(S):

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Facility staff physically assaulted client

INVESTIGATION FINDINGS:

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On 4/26/25, the California Department of Social Services Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Deborah Lee conducted a subsequent complaint visit for the purpose of continuing investigation and to deliver findings. LPA Lee met with Zoe Wilson Administrator who assisted with this visit.

Investigation consisted of:
On 4/10/25-4/22/25, LPA Lee obtained (via email) and reviewed the following documents: Staff roster (dated 4/9/25), Client roster (no date), Clients Rights Training (dated 4/2/25) ProAct (de-escalation crisis training certificates (dated: 11/17/24, 8/17/24, 6/30/24, Admission Agreement (dated 4/8/24, 3/19/21, 6/13/12, 8/30/10, 7/6/05).

On 4/18/25 and 4/21/25, LPA Lee conducted telephone interviews with 5 staff (S1-S5) and Administrator Wilson.
On 4/26/25 LPA Lee and Administrator Wilson toured the facility inside and out conducted interviews with 4 clients (C2 -C5).

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2025

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 18-AS-20240226162230

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ALTA II	FACILITY NUMBER: 374602093
	VISIT DATE: 04/27/2025

NARRATIVE

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On 4/27/25, LPA interviewed 1 client (C6), and reviewed C2-C6’s Individual Program Plan (IPP).

Investigation revealed the following:

Allegation: Facility staff physically assaulted client

The details of the complaint allege that on 11/23/24, C1 left the home and two of the male caretakers had to wrestle C1 down on the asphalt in the middle of the street.

On 4/15/25, LPA Lee conducted a telephone interview with Zoe Wilson, Administrator (A1), who denied the allegation stating that on 11/23/24, staff were doing a two person lift and C1 became aggressive. A1 further stated that the staff were trying to stop C1 from running into the street as C1 was attempting to jump on cars which poses a potential danger to C1 and the staff. Lastly, A1 states that all the staff are certified in ProAct (de-escalation crisis training).

On 4/18/25 and 4/21/25 LPA Lee conducted telephone interviews with 5 staff (S1-S5). 5 out of 5 denied the allegation stating that staff has never assaulted a client. 5 out of 5 staff also stated that they know how to use de-escalation techniques when needed.

On 4/22/2025, LPA Lee reviewed ProAct (de-escalation crisis training) certificates for all staff (dated: 11/17/24, 8/17/24, 6/30/24) which indicates that they are current with the required de-escalation training for the level of care they provide.

On 4/26/25 between 8:30am and 11:00am, LPA Lee interviewed 4 Clients (C2-C5). LPA could not interview Client #1 (C1) as C1 no longer lives at the facility.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2025

LIC9099 (FAS) - (06/04)

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Control Number 18-AS-20240226162230

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ALTA II	FACILITY NUMBER: 374602093
	VISIT DATE: 04/27/2025

NARRATIVE

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Of those interviewed, 4 out of 4 clients stated that they like living in the facility and that staff has never hit them or ever wrestled them to the ground. 4 out of 4 clients interviewed stated that they are aware of their right to be treated with dignity and respect.

On 4/27/25, 1 out of 1 client interviewed stated that they likes living in the facility and that staff treats the clients with dignity and respect.

Based on LPA’s interviews and records reviewed, the preponderance of the evidence has not been met, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies were cited for the above allegation. Exit interview was conducted. A copy of this report was provided to Zoe Wilson, Administrator.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2025

LIC9099 (FAS) - (06/04)

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