374602902-5-24-2023-08-AS-SJAB-CSCSA5-20230531134148

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374602902
Report Date: 05/24/2023
Date Signed: 05/24/2023 01:33:04 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/19/2020 and conducted by Evaluator Iby Strong

COMPLAINT CONTROL NUMBER: 08-AS-20200619134038

FACILITY NAME:	LYN'S HOME CARE III		FACILITY NUMBER:	374602902
ADMINISTRATOR:	ABILLE, LYDIA		FACILITY TYPE:	735
ADDRESS:	186 MOSS ST		TELEPHONE:	(619) 426-2804
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91911
CAPACITY:	6	CENSUS: 6	DATE:	05/24/2023
		UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Administrator Lydia Abille		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Facility Staff do not accord client dignity.
Facility staff did not accord client safe accommodations.
Facility staff do not safeguard client's property.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to deliver findings in the above complaint allegations. LPA identified herself and discussed the purpose of the visit with Administrator Lydia Abille.

On June 19, 2020, Community Care Licensing (CCL) received a complaint alleging facility staff did not accord Client 1 (C1) dignity, facility did not accord C1 safe accommodations and facility staff did not safeguard C1’s property.

During investigation, LPA Strong reviewed available records, conducted a facility inspection and conducted interviews. According to allegations C1’s dignity had not been respected as C1 had been locked out of the facility multiple times and staff asked C1 if C1 was wearing adult incontinence briefs. According to interview with Administrator, Administrator is not aware of any incident where C1 was locked out of the facility. Interview with Administrator also revealed that there were no instances where C1 was asked about their undergarment use.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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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Control Number 08-AS-20200619134038

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: LYN'S HOME CARE III	FACILITY NUMBER: 374602902
	VISIT DATE: 05/24/2023

NARRATIVE

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Interview with client present revealed no issues with client’s being mistreated or being locked out of facility.

It was also alleged that C1 was threatened by C2 which resulted in C1 not having safe accommodations. Interview Administrator revealed that she was not aware of any issues between C1 and C2. Administrator also revealed that C1 and C2 never shared a room and there were no known incidents between the two. Interview with client present revealed that they feels safe at the facility and has not witnessed any incidents between other clients.

Lastly, it was alleged that C1 had personal items stolen. Interview with Administrator revealed that it was never reported to staff that items were missing. Information collecting during investigation corroborated that C1 never reported missing items. Interview with client’s present revealed that no similar items had been stolen from client while at the facility.

Based on LPA's interviews, and lack of corroborating information there is not a preponderance of evidence to prove alleged violations occurred, therefore the allegations are unsubstantiated. An exit interview was conducted with Administrator Lydia Abille to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.

SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

LIC9099 (FAS) - (06/04)

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