374603579-3-13-2026-08-AS-SJAB-DSBQA5-20260319115922

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603579
Report Date: 03/13/2026
Date Signed: 03/13/2026 02:29:43 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
06/25/2021 and conducted by Evaluator Dang Nguyen

COMPLAINT CONTROL NUMBER: 08-AS-20210625144104

FACILITY NAME:	ESPERANZA'S HOMES OF HOPE		FACILITY NUMBER:	374603579
ADMINISTRATOR:	SABRINA SNYDER		FACILITY TYPE:	735
ADDRESS:	13706 WHISPERING MEADOWS LANE		TELEPHONE:	(619) 825-6159
CITY:	JAMUL	STATE: CA	ZIP CODE:	91935
CAPACITY:	6	CENSUS: 5	DATE:	03/13/2026
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Caregiver Elsa Ramirez and Licensee/Administrator Sabrina Snyder		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility staff did not give medication as prescribed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced subsequent visit to deliver a finding regarding the above prior complaint allegation. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Elsa Ramirez. LPA also spoke with Licensee/Administrator Sabrina Snyder, who arrived later during the visit.

The Complainant alleged that facility staff did not give Client #1 (C1) their medication as prescribed. [See LIC811 Confidential Names List for a description of select person identifiers used in this report.] CCLD’s investigation involved multiple unannounced facility tours/welfare checks and interviews of relevant clients, staff, and outside sources. The Department also reviewed pertinent care and medication records.

[CONTINUED ON LIC 9099-C, 1 of 2]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

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 3

Control Number 08-AS-20210625144104

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: ESPERANZA'S HOMES OF HOPE	FACILITY NUMBER: 374603579
	VISIT DATE: 03/13/2026

NARRATIVE

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[CONTINUED FROM LIC 9099]

The Complaint alleged that on a day in early June 2021, they observed C1 appearing drowsy and overmedicated. They said C1 couldn’t finish their sentences or walk without swaying/nearly falling. The Complainant said C1 had started on new Haldol and Thorazine medications since moving into the facility back in March 2021.

According to C1’s LIC602 Physician’s Report, C1 was diagnosed with both developmental disability and mental disability. Per C1’s Individual Program Plan (IPP), which San Diego Regional Center (SDRC) wrote before C1 even moved into Esperanza’s Homes of Hope: C1 had a history of AWOL (i.e., exit-seeking / running away) behavior and when upset tended to display “emotional outbursts including yelling, cursing, stamping [their] feet, pushing staff, physical aggression, spitting at others, self-injury attempts (hitting her arm and legs, pulling [their] hair, and banging their] head), and property destruction.” C1 had already been taking “prescribed behavior modification drugs,” to include “antipsychotics” and “antidepressants,” prior to move in.

LPA interviewed C1’s assigned SDRC Coordinator/Social Worker, who confirmed that C1 had challenging AWOL behaviors, and that C1’s psychiatrist recently added/ordered Haldol and Thorazine to C1’s list of prescribed medicines. The SDRC Coordinator had no knowledge suggesting facility staff had deviated from physician’s orders. LPA interviewed C1’s responsible person (RP), who confirmed that C1 had challenging AWOL behaviors at their last residence (just before moving into Esperansa’s Homes of Hopes), and stated that any medication increases for C1 around this time were likely justified/warranted. C1’s RP had no knowledge suggesting facility staff had deviated from physician’s orders during this time.

LPA reviewed C1’s Medication Administration Records (MARs), which showed: Starting 03/25/2021, C1’s psychiatrist prescribed them a routine 50 mg/ml Haldol intramuscular injection once every two weeks, but by 04/16/2021 had discontinued it. Starting 03/25/2021, C1’s psychiatrist prescribed them an as-needed Thorazine 50 mg tablet up to once every four (4) hours, but by 04/16/2021 had replaced it with a routine 100mg tablet four (4) times per day. There was nothing in C1’s MARs to suggest that C1 received more Haldol than prescribed during the time that order was active. There was nothing in C1’s MARs to prove that facility staff were too liberal with giving C1 Thorazine during the time it was an as-needed (PRN) prescription. There was nothing in C1’s MARs to prove that facility staff had given C1 more Thorazine than prescribed even after it became a routine prescription. [CONTINUED ON LIC 9099-C, 2 of 2]

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20210625144104

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: ESPERANZA'S HOMES OF HOPE	FACILITY NUMBER: 374603579
	VISIT DATE: 03/13/2026

NARRATIVE

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[CONTINUED FROM LIC 9099-C, 1 of 2]

Interviews of facility staff showed C1’s psychiatrist generally met with their assigned clients about once every two (2) weeks to re-evaluate them, adjusting medication dosages if needed. Interviews, corroborated by a desk calendar entry, even showed that a facility manager and a facility caregiver on 06/23/2021 traveled to C1’s psychiatrist’s office to share feedback from C1’s RP regarding C1's medications, to help facilitate the doctor’s decision-making.

According to the National Institutes of Health, the average/typical Thorazine dosage for a patient is between “300-800 mg/day.” During the complaint review period, C1 never received more than 400 mg of Thorazine per day, in practice. According to the National Institutes of Health, the maximum recommended dosage of intramuscular Haldol for treatment of Schizophrenia (which C1 had) was “450 mg once every 4 weeks.” During the complaint review period, C1 was prescribed a dosage of Haldol that was less than a quarter of the recommended maximum.

When LPA met with C1 on 07/02/2021, C1 was alert and had no difficulty walking. C1 denied feeling drowsy, sleepy, or dizzy, either on that date or in the preceding weeks, and concluded, “I’m fine.” C1 was not aware of facility staff making any errors with their medications or deviating from prescriptions.

LPA also met with each of C1’s housemates, who all were alert and had no difficulty walking or speaking. All housemates said they were not aware of facility staff making any errors with their own medications and opined that C1 did not appear drowsy/dizzy to them. LPA also interviewed the responsible persons (RPs) for each of C1’s housemates; none of these persons suspected that facility staff deviated from clients’ prescribed medication dosages during the complaint time period.

Based on records and interviews, a preponderance of evidence does not exist to show that facility staff did not give medication as prescribed during the complaint time period. The allegation is therefore Unsubstantiated, and no deficiency was cited for it.

An exit interview was conducted with Licensee/Administrator Sabrina Snyder, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2026

LIC9099 (FAS) - (06/04)

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