374602673-10-13-2023-08-AS-DPOL-CWPNFH-20231017102531

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602673
Report Date: 10/13/2023
Date Signed: 10/13/2023 02:35:48 PM

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
07/27/2020 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20200727144349

FACILITY NAME:	CASA ESTRELLA 11TH ST		FACILITY NUMBER:	374602673
ADMINISTRATOR:	MICHELLE MUNOZ		FACILITY TYPE:	735
ADDRESS:	1125 11TH STREET		TELEPHONE:	(619) 651-1177
CITY:	IMPERIAL BEACH	STATE: CA	ZIP CODE:	91932
CAPACITY:	6	CENSUS: 5	DATE:	10/13/2023
		UNANNOUNCED	TIME BEGAN:	02:26 PM
MET WITH:	Michelle Munoz, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Licensee did not meet client's needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit to close out the complaint investigation regarding the above-mentioned allegation. LPA identified herself and met with Michelle Munoz Adminstrator, to discuss the purpose of the visit and elements of the complaint.

It was alleged that the licensee did not meet client's needs. Interviews revealed Client 1 (C1) was admitted to the hospital on July 25th, 2020 with food impaction issues. Interviews with outside sources revealed that they were concerned that the facility staff may be neglecting C1 by not assisting them with meal service. Interviews with staff revelaed this is not true and interviews revealed all staff do their due dillegience and the best they can while taking care of C1. Interviews with staff revealed they cut up C1's food and staff watch them eat. Interviews revealed that they give C1 a soft food diet along with staff cutting up C1's meat very small when they are eating meat. Interviews revealed the staff are meeting the clients needs by cutting up the food and standing next to the client during meal times. The allegation is unsubstantiated. The allegation is therefore determined to be unsubstantiated, since the preponderance of evidence standard was not met.

An exit interview was conducted with Michelle Munoz Adminstrator. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided and their signature on this report confirms receipt of the Licensee Rights.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

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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