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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602441
Report Date: 05/22/2023
Date Signed: 05/22/2023 11:20:24 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
02/08/2023 and conducted by Evaluator Renita Hall
COMPLAINT CONTROL NUMBER: 08-AS-20230208184518
FACILITY NAME:SAM & ROSE STEIN EDUCATION CENTERFACILITY NUMBER:
374602441
ADMINISTRATOR:PONCE, SERGIOFACILITY TYPE:
775
ADDRESS:4990 WILLIAMS AVETELEPHONE:
(619) 463-3300
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:45CENSUS: 40DATE:
05/22/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Melinda Williams, Program SupervisorTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Licensee did not follow infection control requirements
Licensee did not conduct fire drills
Licensee locked facility doors
Licensee did not follow reporting requirements
Staffing levels did not meet resident needs
Staff did not receive required training
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Renita Hall conducted an unannounced visit to deliver findings. LPA was allowed entry by the Program Supervisor Melinda Williams. LPA identified herself and disclosed the purpose of the visit and elements of the findings with the Program Supervisor Melinda Williams.

The Department investigated the above listed complaint allegations. The investigation consisted of a tour of the facility, interviews of staff and records review.

Review of records showed that fire drills were conducted, trainings were conducted with verification of an employee sign sheet, and infection control requirements were followed by sending in incident reports. Staffing levels were adequate for number of clients, specifically there was one staff scheduled on duty for every six clients in the program. Review of staffing schedule confirmed that sufficient staff were present to meet client needs.
Continued on 9099C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
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-20230208184518
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SAM & ROSE STEIN EDUCATION CENTER
FACILITY NUMBER: 374602441
VISIT DATE: 05/22/2023
NARRATIVE
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On 02/13/2023 facility doors were observed as unlocked and entering and exiting the building was not of concern at the time of visit. Staff interview statements noted that doors were routinely left open during hours of operation.

The Department's review of records and observation found there was insufficient evidence to support the allegations that Licensee did not follow infection control requirements; Licensee did not conduct fire drills; Licensee locked facility doors; Staffing levels did not meet resident needs; Licensee did not follow reporting requirements; Staff did not receive required training. Due to a lack of evidence, the allegations are deemed to be unsubstantiated. A finding that is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with the Program Supervisor Melinda Williams. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Program Supervisor Melinda Williams and her signature on this report confirms receipt of the Licensee Rights.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2