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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603756
Report Date: 01/27/2023
Date Signed: 01/27/2023 11:53:28 AM

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
04/04/2022 and conducted by Evaluator Iby Strong
COMPLAINT CONTROL NUMBER: 08-AS-20220404144847
FACILITY NAME:BELLAS FACILITYFACILITY NUMBER:
374603756
ADMINISTRATOR:CASTRO, JONATHANFACILITY TYPE:
735
ADDRESS:2024 HIDDEN MESA ROADTELEPHONE:
(619) 328-2291
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:4CENSUS: 4DATE:
01/27/2023
UNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Administrator Jonathan CastroTIME COMPLETED:
11:20 PM
ALLEGATION(S):
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Client sustained unexplained bruising while in care.
Licensee did not meet the client's grooming needs.
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 Direct Support Professional Gerardo Calzada. Administrator Jonathan Castro arrive shortly after.

On April 4th, 2022, Community Care Licensing (CCL) received a complaint alleging Client 1 (C1) sustained unexplained bruising while in care and licensee did not meet C1’s grooming needs.

During investigation, LPA Strong collected pertinent client records as well as facility documentation. Based on C1’s Physician Report dated June 10th, 2019, C1 is diagnosed with Trisomy 21, seizures and impulse control disorder; C1 requires assistance with all grooming, medication, bathing, and toileting. Additionally, C1’s Individual Program Plan dated February 21st, 2019, states C1 has episodes of self-injury and physical aggression towards others.
Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
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 2
Control Number 08-AS-20220404144847
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: BELLAS FACILITY
FACILITY NUMBER: 374603756
VISIT DATE: 01/27/2023
NARRATIVE
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Continued from LIC9099

According to allegations received, C1 sustained unexplained bruising while in care but no date of incident was provided. Based on records collected, C1 was last at facility on February 5th, 2022. During interview with Administrator, it was revealed that on February 5th, 2022, emergency personnel were contacted due to C1 having difficulty standing, C1 was then admitted to the hospital where C1 remained for observation and recovery. Administrator also revealed C1 was previously taken to a local emergency room on January 11th, 2022, after C1 had a severe seizure that resulted in a fall and a large bruise was sustained on the left side of the head. Additional photographs collected showed a large healing bruise on the back of a short-haired person, this photograph was expressed to have been taken on February 14th, 2022, of C1 but LPA Strong was not able to verify this information. According to outside source interview, C1 has multiple seizures a year, which result in bruising and other minor injuries. Outside source also revealed that C1 has self-injurious behaviors which have caused injuries to extremities. Outside source also revealed that C1 had a decline in mobility since September 2021 due to declining health and facility has no history of neglect or physical abuse. Records collected from facility corroborated that C1 had multiple seizures and one self-injurious event since September 2021.

Additionally, it was alleged that C1 did not receive toenail care within an undetermined time frame. During investigation, photographs collected revealed a picture of a left-foot with a thick toenail but short in length. LPA Strong was unable to verify if this photograph was of C1. According to interview with administrator C1 only allowed specific staff to provide nail-care, including administrator and one additional caregiver. Interviews with staff revealed that C1 received nail-care weekly from administrator or the caregiver C1 liked. Interview with outside source revealed there were no issues with grooming care at the facility.

Based on LPA's interviews with staff, outside source interviews, and record reviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegations are unsubstantiated. An exit interview was conducted with Administrator Jonathan Castro, 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: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2