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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602306
Report Date: 12/20/2024
Date Signed: 12/20/2024 10:47:54 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
02/16/2024 and conducted by Evaluator Armando Perez
COMPLAINT CONTROL NUMBER: 18-AS-20240216143614

FACILITY NAME:RUBIA'S TERRACE ARFFACILITY NUMBER:
374602306
ADMINISTRATOR:MERCEDES RUBIAFACILITY TYPE:
735
ADDRESS:2660 GROTON PLACETELEPHONE:
(760) 520-3951
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:6CENSUS: DATE:
12/20/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Licensee, Mercedes RubiaTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
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9
Staff did not ensure facility is in good repair
Staff did not ensure residents had hot water
Staff did not ensure facility is in sanitary condition
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
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12
13
Licensing Program Analyst (LPA), Armando Perez, arrived unannounced for a visit to deliver the findings for the above allegations. LPA met with Licensee, Mercedes Rubia, and explained the purpose of the visit. During the course of the investigation, LPA Jacqueline Shaw Ross initiated the complaint investigation on February 21, 2024 and interviewed staff, clients and obtained pertinent documentation. On December 12, 2024, LPA Armando Perez continued the investigation, conducted telephone interviews and requested documentation pertinent to the allegations.

On February 16, 2024, Community Care Licensing (CCL) received a complaint investigation alleging that staff did not ensure facility is in good repair, staff did not ensure residents had hot water, and staff did not ensure facility is in sanitary condition. It was reported that sewege water was overflowing from the septic tank, residents did not have access to hot water and the facility was not in sanitary condition.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Armando Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
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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