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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603818
Report Date: 09/13/2023
Date Signed: 09/13/2023 12:24:33 PM

Substantiated


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
06/14/2023 and conducted by Evaluator Dawn Segura
COMPLAINT CONTROL NUMBER: 08-AS-20230614101206
FACILITY NAME:EUBANK CASTLEFACILITY NUMBER:
374603818
ADMINISTRATOR:ANETA STANEK DE LAFACILITY TYPE:
735
ADDRESS:1528 SANGAMON AVENUETELEPHONE:
(619) 825-6473
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:6CENSUS: 5DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Monica McDade, Program ManagerTIME COMPLETED:
12:35 PM
ALLEGATION(S):
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Facility staff mentally abused client while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigative findings. LPA introduced herself, was granted entry into the facility, and met with Monica McDade, Program Manager, to whom LPA disclosed the reason for the visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of a tour of the facility, review of facility records, and interviews of clients, staff, and outside sources.

It was reported to Community Care Licensing that Client 1 (C1) [an LIC 811 Confidential Names List was provided to identify the parties] was mentally abused by staff while in care.

Evidnce from the investigation revealed that C1 moved into the home within the last few months and has
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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-20230614101206
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: 09/13/2023
NARRATIVE
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lived there only a short time. Records reviewed reflect that C1 has been diagnosed with intellectual disability and episodic mood disorder, along with other diagnoses. Records reviewed and interviews conducted during the investigation yielded that, since moving into the home, C1 has had verbal altercations with staff, during which inappropriate, demeaning, and, at times, provocative language has been spoken by staff to C1.

Evidence reflected that Staff 1 (S1) spoke to C1 in a confrontational and argumentative manner in the presence of other staff and outside parties. Evidence also revealed that S1 belittled C1, making statements such as “it’s you on medication, not me.” Interviews further revealed that S1 was heard stating to C1, “respect my boundaries, don't walk up on me, and step off of me.” Interview also yielded that Staff 2 (S2) regularly used profanity when speaking in the presence of and to C1.

Based upon information obtained during the investigation, actions taken by staff triggered aggression and explosive episodes from C1 and fostered an environment that did not provide a welcoming or healthy relationship between staff and C1. Considering all of the foregoing, the allegation is substantiated. This finding means that the preponderance of the evidence standard has been met and the allegation is valid. Deficiency is cited per California Code of Regulations, Title 22, and is noted on the attached LIC9099-D.

An exit interview was conducted with Monica McDade, and copies of this report and Licensee Rights were provided to the Program Manager at the conclusion of the visit. Her signature on this report acknowledges receipt of copies of the report and the rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 08-AS-20230614101206
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/11/2023
Section Cited
CCR
80065(l)
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Personnel Requirements. Personnel shall provide for the care and safety of persons without physical or verbal abuse, exploitation or prejudice.
This requirement was not met as evidenced by:
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Program Manager informed LPA that S1 and S2 have been terminated. Program Manager plans to have all staff attend personal rights training and staff burnout training provided by an outside vendor. Proof of training will be provided to Community Care Licensing by the POC due date.
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Based on interviews, licensee did not ensure that C1, 1 of 4 clients in care, was provided care without verbal/mental abuse. This posed a potential personal rights violation to 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: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
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
06/14/2023 and conducted by Evaluator Dawn Segura
COMPLAINT CONTROL NUMBER: 08-AS-20230614101206

FACILITY NAME:EUBANK CASTLEFACILITY NUMBER:
374603818
ADMINISTRATOR:ANETA STANEK DE LAFACILITY TYPE:
735
ADDRESS:1528 SANGAMON AVENUETELEPHONE:
(619) 825-6473
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:6CENSUS: 5DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Monica McDade, Program ManagerTIME COMPLETED:
12:35 PM
ALLEGATION(S):
1
2
3
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5
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9
Facility staff threatened client while in care.
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to deliver investigative findings. LPA introduced herself, was granted entry into the facility, and met with Monica McDade, Program Manage, to whom LPA disclosed the reason for the visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of a tour of the facility and interviews of clients, staff, and outside sources.

It was reported to Community Care Licensing that facility staff threatened C1 while in care. It was alleged that S1 would call C2 to intervene and intercede on S1’s behalf, as S1 was aware that staff could not physically engage with clients in care. The investigation produced no evidence to conclude that C2 engaged in any physical altercations with C1 on behalf of staff or that S1 summoned C2 as a means of intimidation or as a threat of action to C1.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20230614101206
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: 09/13/2023
NARRATIVE
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Based upon the foregoing, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Monica McDade, and copies of this report and Licensee/Appeal Rights (LIC 9058) were provided to the Program Manager at the conclusion of the visit. Her signature below serves as acknowledgment of receipt of copies of the report and rights.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5