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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602717
Report Date: 11/07/2025
Date Signed: 11/07/2025 11:00:23 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
07/10/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250710090626
FACILITY NAME:M & M RESIDENTIALFACILITY NUMBER:
374602717
ADMINISTRATOR:JENKINS, MAKAILA AFACILITY TYPE:
735
ADDRESS:1504 WHITESTONE ROADTELEPHONE:
(619) 825-8487
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:4CENSUS: 3DATE:
11/07/2025
UNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:Mia Brown, AdministratorTIME COMPLETED:
10:36 AM
ALLEGATION(S):
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Staff allows clients to consume alcoholic beverages in the facility
Staff do not ensure sharp knives made inaccessible to clients in care
Staff does not prevent client for engaging in verbal altercations with other client in care
Staff does not ensure adequate care and supervision is provided to clients in care
Staff speaks inappropriately to clients in care
Staff did not ensure medications were dispensed as prescribed to client in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to open complaint on the above-mentioned allegations. LPA identified herself, and met with XX to discuss the purpose of the visit.

LPA was able to conduct a physical inspection of the facility, and collected relevant records, and was able to conduct interviews. It was alleged that the staff allows clients to consume alcoholic beverages in the facility. Interviews revealed there is one client that snuck an alcoholic beverage into the home in their back pack. Interviews revealed that the client drank it in their room. Interviews with staff revealed that the client has brought alcohol to the facility without their knowledge and once they found out about the incident they pulled the client to the side and spoke with them about not drinking in the facility.Interviews revealed the staff does not let the clients drink in the facility. Interviews revealed that the staff let the clients smoke marijauana outside. Interviews revealed the clients know the house rules which are no drugs or alcohol in the house. There is nothing in that clients physicians report or Individual Program Plan that stated they cannot have a drink.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
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 5
Control Number 08-AS-20250710090626
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: M & M RESIDENTIAL
FACILITY NUMBER: 374602717
VISIT DATE: 11/07/2025
NARRATIVE
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It was alleged that the staff do not ensure sharp knives made inaccessible to clients in care. Interviews revealed there are knives available for the clients to use. Interviews revealed the extra sharp knives are held and locked in the living room closet for clients to use with supervision for instance when cutting meat or vegetables and things like that. The use of knives are allowed and not against regulation to have in drawers accessible to clients. Interviews with an outside source revealed that the staff may cook with sharp knives and then remove the knives when done.

It was alleged that the staff does not prevent client from engaging in verbal altercations with other client in care. Interviews revealed the clients argue sometimes and the staff will let them talk or argue it out but will always intervene if it gets too serious or if staff believe it will lead to the clients being physical. Interviews revealed that the clients can usually talk things out and solve their issues on their own but the staff are there when they cannot. Interviews revealed that staff denied letting the clients engage in verbal altercations. Interviews with an outside source stated they don't know how the staff redirect the clients if they are arguing but they have not received any complaints about staff letting clients engage in verbal altercations.

It was alleged that the staff does not ensure adequate care and supervision is provided to clients in care. Interviews revealed there is staff at the facility anytime there are clients there. Interviews revealed there is two staff that are supervising the clients and once all of the duties are done around the facility there is one that plays video games with the other clients. Interviews revealed the staff has permission as long as the facility duties are complete and the clients needs are met. Interviews revealed that staff still assists the clients when they need it and that the staff is in the living room playing the game and the clients are usually in there room or in the living room also watching or playing. Staff denied the allegation of not ensuring adequate supervision for the clients.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
07/10/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250710090626

FACILITY NAME:M & M RESIDENTIALFACILITY NUMBER:
374602717
ADMINISTRATOR:JENKINS, MAKAILA AFACILITY TYPE:
735
ADDRESS:1504 WHITESTONE ROADTELEPHONE:
(619) 825-8487
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:4CENSUS: 3DATE:
11/07/2025
UNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:Mia Brown, AdministratorTIME COMPLETED:
10:36 AM
ALLEGATION(S):
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Staff turns off electricity in facility as a form of punishment to clients in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to open complaint on the above-mentioned allegation. LPA identified herself, and met with Mia Brown, Administrator to discuss the purpose of the visit.

LPA was able to conduct a physical inspection of the facility, and collected relevant records, and was able to conduct interviews. It was alleged that the staff turns off electricity in facility as a form of punishment to clients in care. Interviews revealed there is one client that usually stays home from program and the staff will be at the facility with them or they will be out in the community with staff. Interviews revealed there was one day when the Client 1 (C1) was not listening to staff and they turned off the electricity from the electric box in the hallway by the front door. Interviews revealed the staff turned off the electricty so the client could not play video games and the client would leave with staff to pick up another client.

Based on the evidence obtained from interviews, records review, and outside sources, the complaint allegation of staff turns off electricity in facility as a form of punishment to clients in care is substantiated. A deficiency is cited on the 9099 D page.

An exit interview was conducted with Mia Brown, Administrator and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 08-AS-20250710090626
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: M & M RESIDENTIAL
FACILITY NUMBER: 374602717
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/28/2025
Section Cited
CCR
80072(a)(3)
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(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement has not been met as evidenced by:
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Licensee will provide training to staff on personal rights. POC is due to CCL by 11/28/2025. Licensee will send over sign in sheet and documents used for the training via email by 11/28/2025
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Based on interviews, staff turned off electricity in facility as a form of punishment to 1 out of 4 clients in care. (C1)
This poses a potential health and safety risk to clients
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20250710090626
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: M & M RESIDENTIAL
FACILITY NUMBER: 374602717
VISIT DATE: 11/07/2025
NARRATIVE
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It was alleged that the staff speaks inappropriately to clients in care. Interviews revealed the staff speak to clients with respect. Interviews revealed that the staff speak to the clients with a calm tone and that the clients are usually the ones that yell and cuss at them. Interviews with staff denied the allegation of speaking to the clients inappropriately. Interviews with an outside source revealed they have no complaints about the way the staff speak to the clients in care.

It was alleged that the staff did not ensure medications were dispensed as prescribed to client in care. Interviews revealed the clients get their medications on time and how the doctor has ordered them to get them. Interviews revealed the only time a client may not get their medications is if they refuse the medications. Interviews revealed that the clients get medications in the am before leaving for program and afternoon and evening medications when they come home from program. Interviews with staff denied that the clients are not getting their medications. Interviews with an outside source revealed they have no concerns with the way the medication is being dispensed to the clients.

Based on the evidence obtained from interviews, records review, and outside sources, the complaint allegations staff allows clients to consume alcoholic beverages in the facility, staff do not ensure sharp knives made inaccessible to clients in care, staff does not prevent client for engaging in verbal altercations with other client in care, staff does not ensure adequate care and supervision is provided to clients in care, staff speaks inappropriately to clients in care and staff did not ensure medications were dispensed as prescribed to client in care are all unsubstantiated.

An exit interview was conducted with XXX and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5