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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602666
Report Date: 06/17/2025
Date Signed: 07/09/2025 11:41:24 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
09/20/2024 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20240920144328
FACILITY NAME:APK SERENE, KERNFACILITY NUMBER:
374602666
ADMINISTRATOR:LINDA GRUBBFACILITY TYPE:
735
ADDRESS:19 KERN CTTELEPHONE:
(760) 722-2757
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:5CENSUS: 0DATE:
06/17/2025
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Report mailed to Licensee via
certified US mail
TIME COMPLETED:
06:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not accord client's dignity
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 07/02/2025 Licensing Program Analyst (LPA) Tiffany Holmes generated the complaint findings and mailed via certified U.S. mail the complaint report to the listed address for the Licensee.
Background of the Complaint:
LPA conducted conducted a tour of the facility on 09/25/2024. LPA was able to interview facility staff, and outside sources to interview clients due to all clients being non verbal.
Investigation Findings:
It was alleged that staff did not accord client's dignity. Interviews with staff denied them sleeping in one of the clients rooms. Interviews revealed that the staff have their own room that has a daybed in it with a trundle for two people to sleep. Interviews revealed the two staff are live in caregivers. Interviews revealed that LPA Borruda advised LPA Holmes that they oversaw and verified that the three (3) clients that were in care were safely moved out of the facility, along with their current medications, basic client records, Personal and Incidental (P&I) monies, and essential clothing and belongings on 10/24/2024. According to staff and LPA Borruda all clients are non verbal and not able to be interviewed.
Conclusion:
The investigation did not produce supporting evidence or supporting witness statements to substantiate staff did not accord client's dignity. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

No signatures were obtained due to the facility's closure, effective 05/03/2025. A copy of this report, along with appeal rights, was mailed to the Licensee via certified U.S. Mail.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
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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