374603818-2-23-2023-08-AS-JRAE-CPH34F-20230228165504

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603818
Report Date: 02/23/2023
Date Signed: 02/23/2023 10:40:25 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
12/08/2021 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20211208085935

FACILITY NAME:	EUBANK CASTLE		FACILITY NUMBER:	374603818
ADMINISTRATOR:	ANETA STANEK DE LA		FACILITY TYPE:	735
ADDRESS:	1528 SANGAMON AVENUE		TELEPHONE:	(619) 825-6473
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY:	6	CENSUS: 4	DATE:	02/23/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Monica McDade, Program Administrator		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Staff physically abused client
Staff verbally abused client
Licensee did not protect client in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmes conducted a complaint visit to close out the investigation. LPA was greeted at the front door by Monica McDade, Program Administrator and granted entry after identifying herself and disclosing the reason for her visit.

It was alleged that staff physically abused client. Interviews revealed staff have not physically abused any clients. Interviews revealed staff that were questioned denied any allegation of physically abusing any of the clients that are in care.There were no witnesses to Client 1 (C1) being physically abused.

It was also alleged that staff verbally abused client. Interviews revealed that clients in care did not report any verbal abuse to staff. Interviews also revealed that staff talk and treat the clients with respect and dignity.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

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-20211208085935

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: EUBANK CASTLE	FACILITY NUMBER: 374603818
	VISIT DATE: 02/23/2023

NARRATIVE

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Interviews revealed there were no witnesses to Client 1 (C1) being verbally abused by staff. Interviews revealed that other clients have not experienced staff verbally abusing them. Interviews revealed staff talk to them nicely. The staff do not raise their voices at the clients.

Lastly, it was alleged that the licensee did not protect clients in care. Interviews with clients revealed they feel safe in and around the facility. Interviews revealed that staff are kind and watch over them at all times. Interviews revealed the staff come and check on them while they are in their rooms during their shifts. It was also revealed that staff keep the clients safe from other clients and from staff. There were no witnesses to licensee did not protect clients in care.

Interviews did reveal that C1 has a history of making false accusations against group home staff, and pumps up the accusations to seek attention. According to C1 Individualized Program Plan (IPP) it states that C1 is working on an outcome to stop lying.

Allegations of staff physically abused client, staff verbally abused client and licensee did not protect client in care are unsubstantiated. An exit interview was conducted with Monica Mcdade, Program Administrator. A copy of this report and Licensee Appeal Rights (9058 03/22) were provided to Administrator after the conclusion of the visit.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023

LIC9099 (FAS) - (06/04)

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