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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602179
Report Date: 12/15/2022
Date Signed: 12/16/2022 08:02:43 AM

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
09/22/2020 and conducted by Evaluator Natasha Persaud
COMPLAINT CONTROL NUMBER: 08-AS-20200922132853
FACILITY NAME:TENDER LOVING CARE GUEST HOMEFACILITY NUMBER:
374602179
ADMINISTRATOR:VICTORIA S. LEGASPIFACILITY TYPE:
740
ADDRESS:1430 SHERYL LNTELEPHONE:
(619) 399-3552
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:6CENSUS: 6DATE:
12/15/2022
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Administrator, Victoria LegaspiTIME COMPLETED:
03:25 PM
ALLEGATION(S):
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-Licensee did not provide supervision to residents in care
-Licensee did not provide daily diet to meet the residents needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Natasha Persaud concluded the complaint investigation regarding the above mentioned allegations. LPA was greeted and allowed entry into the facility and met with Administrator, Victoria Legaspi.

During the investigation, the facility was briefly toured, records reviewed, and interviews conducted with staff, residents, and outside sources. It was alleged the licensee did not provide supervision to residents in care. It was reported the licensee was the only staff working on Sunday, 09/20/20 and left the facility from 8am-9pm, leaving the residents unsupervised. Licensee’s interview revealed she has never left the residents unsupervised. Licensee stated if she needed to leave the facility she would ensure there was staff coverage. Staff interviews revealed they do not work on the weekends, the licensee covers the weekend shift. Therefore, they were not present on 09/20/20. Staff also revealed the licensee would not leave the residents unsupervised, in their opinion. In addition, staff revealed residents did not complain or mention being left unsupervised. Resident interviews revealed they have not been left unsupervised, as staff and/or licensee are present. Outside source interviews revealed never witnessing the residents left unsupervised.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
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-20200922132853
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: TENDER LOVING CARE GUEST HOME
FACILITY NUMBER: 374602179
VISIT DATE: 12/15/2022
NARRATIVE
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It was also alleged the licensee did not provide a daily diet to meet the residents needs. It was reported that due to the licensee leaving the residents unsupervised on 09/20/20 from 8am-9pm, the residents did not receive any food during those hours. Resident interviews revealed they received their meals and have not had to go without food. Resident interviews revealed the kitchen is off limits to the residents. However, the kitchen is not locked and accessible to all. Licensee confirmed the kitchen is off limits to the residents for safety reasons. Anything the residents may need, staff or the licensee will provide it to the residents. Staff interviews revealed the kitchen is off limits to residents, but the kitchen is also accessible to all, as there is no lock or gate. Outside source interviews revealed the residents had access to the kitchen and were able to obtain food at any time. On 09/29/20, LPA observed sufficient perishable and non-perishable food items. LPA confirmed there are no gates or locks to the kitchen area, making it accessible to all.

Based on observations and interviews conducted, the investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Administrator, Victoria Legaspi whose signature below confirms receipt of these rights.

SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Natasha PersaudTELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2