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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603734
Report Date: 03/03/2023
Date Signed: 03/03/2023 12:17:07 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
02/14/2023 and conducted by Evaluator Daniel Pena
COMPLAINT CONTROL NUMBER: 08-AS-20230214162325
FACILITY NAME:SHINING STAR ADULT DAY CARE INCFACILITY NUMBER:
374603734
ADMINISTRATOR:GRIGGS, LAURA CASASFACILITY TYPE:
775
ADDRESS:333 E STREETTELEPHONE:
(619) 651-7446
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:30CENSUS: 26DATE:
03/03/2023
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Lizbeth Jimenez, Program CoordinatorTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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-Facility staff posted photographs of clients on social media
INVESTIGATION FINDINGS:
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On 3/03/2023, Licensing Program Analyst (LPA) Daniel Pena visited the facility regarding the aforementioned complaint allegation. LPA was permitted into the facility after identifying himself and explaining the purpose of the visit. LPA was greeted by and met with Program Coordinator, Lizbeth Jimenez, LPA delivered investigative findings to Ms. Jimenez as facility representative.

On 2/14/2023, the Department received a complaint alleging facility staff posted photographs of clients on their social media. The Department’s investigation consisted of facility visits, record reviews and interviews with clients, staff, and outside sources.

Record reviews included screen shots taken from Staff 1 (S1)’s personal social media accounts. Additionally, LPA visited S1’s social media and observed photographs and videos which included images, later determined to be S1 and clients from the facility. The photographs and videos did not contain identifying information nor were the images inappropriate in nature.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
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-20230214162325
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SHINING STAR ADULT DAY CARE INC
FACILITY NUMBER: 374603734
VISIT DATE: 03/03/2023
NARRATIVE
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Interviews with clients and staff included a review of the images and videos. Clients and staff confirmed that the subjects seen in the photographs were clients and facility staff. During S1’s interview, they admitted to video recording two clients dancing, during a community outing. S1 did this activity to redirect the client's behaviors as the clients were agitated. S1 later allowed the clients to watch the video and it calmed them. S1 explained that the social media platform allows users to create posts in a draft but they are not immediately posted. S1 said they had no intention to post the images on their social media accounts. S1 said they learned that they mistakenly posted them. S1 admitted this to facility supervisors and CCLD what had occurred. S1 has since removed the images from their social media accounts.

The Department investigated the allegation facility staff posted photographs of clients on their social media. Based upon record reviews, interviews and an admission by staff, the preponderance of evidence standard has been met. Therefore, the findings are determined to be Substantiated.

Deficiency is being cited in accordance with the California Code of Regulations, Title 22, Division 6, Chapter 8, and are noted on the attached LIC9099-D.

Program Coordinator, Jimenez was provided a copy of the Licensee’s appeal rights (LIC9058 01/16) and their signature on this form, acknowledges receipt of these rights. An exit interview was conducted, and a copy of this report was provided to Program Coordinator, Jimenez.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20230214162325
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SHINING STAR ADULT DAY CARE INC
FACILITY NUMBER: 374603734
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/03/2023
Section Cited
CCR
80070(c)(2)
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Client Records (c) All information and records obtained from or regarding clients shall be confidential. (2)…the licensee and all employees shall not reveal or make available confidential information. This requirement is not met as evidenced by:
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Licensee ensured the photograph and video images of the clients was removed from staff’s social media account, thereby removing the immediate threat. Licensee agreed to provide training prohibiting staff from taking and posting images of clients on social media. On 2/27/23, Licensee provided CCLD documentation showing that the training was completed by all staff, clearing the POC.
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Based on interviews and record review, facility staff revealed client information. LPA observed photographic and video images of two (2) clients, admittedly posted by facility staff on their social media account which poses a personal rights risk to 2 out of 26 clients in care.
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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: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
02/14/2023 and conducted by Evaluator Daniel Pena
COMPLAINT CONTROL NUMBER: 08-AS-20230214162325

FACILITY NAME:SHINING STAR ADULT DAY CARE INCFACILITY NUMBER:
374603734
ADMINISTRATOR:GRIGGS, LAURA CASASFACILITY TYPE:
775
ADDRESS:333 E STREETTELEPHONE:
(619) 651-7446
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:30CENSUS: 26DATE:
03/03/2023
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Lizbeth Jimenez, Program CoordinatorTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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2
3
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5
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9
-Facility staff transported consumers in an unsafe manner
INVESTIGATION FINDINGS:
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On 3/03/2023, Licensing Program Analyst (LPA) Daniel Pena visited the facility regarding the aforementioned complaint allegation. LPA was permitted into the facility after identifying himself and explaining the purpose of the visit. LPA was greeted by and met with Program Coordinator, Lizbeth Jimenez, LPA delivered investigative findings to Ms. Jimenez as facility representative.

On 2/14/2023, the Department received a complaint alleging facility staff transported clients in an unsafe manner. The Department’s investigation consisted of facility visits, record reviews, and interviews with staff, residents, and outside sources.

Interviews with clients, staff and outside sources did not provide any evidence to substantiate staff transported clients unsafely. Record reviews did not yield information indicating S1 had been counseled or disciplined for unsafe driving practices. This inquiry also did not bring forth evidence S1 was the focus of traffic investigations. No witness has observed S1 transport clients in an unsafe manner.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
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-20230214162325
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SHINING STAR ADULT DAY CARE INC
FACILITY NUMBER: 374603734
VISIT DATE: 03/03/2023
NARRATIVE
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When asked, S1 denied taking photographs or video recording clients while transporting them. Interviews with clients and staff did not produce any corroboration of this allegation.

Based on the evidence obtained and reviewed, the allegation that facility staff transported clients in an unsafe manner is Unsubstantiated as the preponderance of evidence standard was not met. An exit interview was conducted with Program Coordinator, Jimenez and a copy of this report was provided to Ms. Jimenez.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Daniel Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5