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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603818
Report Date: 03/18/2025
Date Signed: 03/18/2025 03:46:34 PM

Document Has Been Signed on 03/18/2025 03:46 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:EUBANK CASTLEFACILITY NUMBER:
374603818
ADMINISTRATOR/
DIRECTOR:		ANETA STANEK DE LAFACILITY TYPE:
735
ADDRESS:1528 SANGAMON AVENUETELEPHONE:
(619) 825-6473
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 6CENSUS: 4DATE:
03/18/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Monica McDade, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced Case Management - Incident visit. LPA was welcomed by and identified herself to Monica McDade, Program Director and discussed the purpose of the visit.

Today's visit was in response to an LIC 624 Incident Report, which licensee self submitted to the CCLD San Diego Regional Office (received on 03/13/2025). This was the first AWOL. According to the LIC 624: on 03/11/2025, Client #1 (C1) went AWOL (absent without leave) from the facility. [See LIC 811 Confidential Names List for a description of C1.] On 03/12/2025, C1 returned to the facility at 9:30pm. Interviews with C1 did not reveal where they were and or what they were doing. Interviews revealed staff asked C1 if they could check their bag since they were gone overnight and they didn't know where they were and C1 told them no. Interviews revealed on this day C1 walked out of the facility with a backpack and walked down to an unknown car and left. Interviews with staff revealed staff and the police tried calling C1 and it went to voicemail each time. Interviews revealed immediately after C1 left they contacted the sheriffs department to report the AWOL.

As of today’s licensing visit, LPA Holmes was advised that C1 AWOL'd again on 03/16/2025 by walking out of the facility with a back pack and staff asking them where they were going and C1 ignoring them. C1 then got into an unknown van and left. Staff notified the sheriffs department, they came and gathered information regarding C1. C1 returned back to the facility on 03/17/2025. LPA performed a facility tour and welfare check on C1 and the other remaining clients in care were at program, finding no immediate safety concerns. LPA also reviewed pertinent records and interviewed relevant staff.

According to C1’s latest LIC 602 Physician’s Report (dated 10/03/2024): C1’s primary diagnoses were Major Depressive Disorder (MDD) without Psychotic features, Major Depressive Disorder, recurrent (HCC). According to C1 physicians report and IPP C1 is not able to safely leave the facility unassisted.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: EUBANK CASTLE
FACILITY NUMBER: 374603818
VISIT DATE: 03/18/2025
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[CONTINUED FROM LIC 809]

According to the facility’s Absentee Notification Plan/Policy: When a client such as C1 is AWOL from the facility, staff are to search the “surrounding area.” After 15 minutes of unsuccessful searching, staff are to notify law enforcement and the client’s responsible person and/or case manager.

Records and interviews revealed: C1 has lived at the facility for around six (6) months, and this was C1’s second AWOL incident since moving in. Prior to the incident, C1 took their prescribed medication and had no issues for the whole day for both incidents. Facility staff called law enforcement and notified C1’s case manager to notify them about C1’s AWOL. A Sheriff’s deputy visited the facility both times, and provided the facility staff with an event number.

CCLD concluded: Facility staff provided needed supervision to C1 leading up to the AWOL. Licensee had a written Absentee Notification Plan as part of C1’s record of care, and staff followed this plan.

No deficiencies were cited for the above two incidents. No deficiencies were observed or cited during today's visit.

An exit interview was conducted with McDade, to whom a copy of this report, the LIC 811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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