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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603818
Report Date: 09/19/2023
Date Signed: 09/19/2023 12:45:41 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
06/15/2023 and conducted by Evaluator Nacole Patterson
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20230615100058
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:
09/19/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Monica McDade, Program ManagerTIME COMPLETED:
12:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff locked resident in garage.
Staff did not provide resident with food.
Resident(s) were not accorded dignity.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Nacole Patterson and LPM Lizzette Tellez conducted an unannounced subsequent visit to deliver findings regarding the above complaint allegation(s). LPA was welcomed by and identified herself to Monica McDade, Program Manager, to whom the purpose of the visit was disclosed.

On 6/15/23 it was alleged that facility staff locked a resident in a garage, did not provide a resident with food, and resident(s) were not accorded dignity. The Department's investigation included two unannounced facility visits, interviews with relevant witnesses, review of pertinent records, and LPA observations.

Regarding the allegation, "Staff locked resident in garage", it was alleged that Staff 2 (S2) locked Resident 1 (R1) in the facility's garage. Staff and resident interviews as well as outside source interviews corroborated that R1 was locked against their will in the garage. Review of facility records confirmed that S2 did lock R1 in the garage and admitted to doing so. (Continued on LIC9099-C)
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
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 6
Control Number 08-AS-20230615100058
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: EUBANK CASTLE
FACILITY NUMBER: 374603818
VISIT DATE: 09/19/2023
NARRATIVE
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32
(Continued from LIC9099)

Regarding the allegation, "Staff did not provide resident with food", it was alleged that staff refused to provide R1 food, upon request.  Interviews with staff and residents were inconsistent, however, all interviews confirmed that residents are given breakfast, lunch, dinner, and two snacks per day at 3pm and 7pm.  All residents interviewed consistently stated that they are not given food outside of these specified times if requested.  Outside source interview corroborated that R1 was not provided an adjusted lunch or between meal snacks after returning to the facility from meeting with a service provider, which resulted in the resident having to wait hours until being served the next meal.

Regarding the allegation, "Resident(s) were not accorded dignity", it was alleged that staff behaved inappropriately and were rude to clients.  Staff interview revealed that Staff 1 (S1) engaged inappropriately with R1 during multiple occasions, escalating arguments instead of de-escalating them.  Staff interview revealed that S1 was terminated for this behavior.  Staff and resident interview revealed that S2 regularly swore in conversation with residents.  Four outside sources interviewed directly observed different staff members being rude to and yelling at residents, instigating letters of concern and meetings to address the issues with the facility.  Review of facility records confirmed that S2 swore in conversation with R1 and was asked by R1 not to use profanity when talking to them.

Based on relevant interviews and records review, the preponderance of evidence has been met that alleged violation(s) occurred and are therefore substantiated.  Deficiencies are cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D).  A Plan of Correction was jointly developed with the licensee. An exit interview was conducted with Monica McDade, Program Manager, to whom a copy of this report, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6
Control Number 08-AS-20230615100058
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: EUBANK CASTLE
FACILITY NUMBER: 374603818
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/19/2023
Section Cited
CCR
80072(a)(7)
1
2
3
4
5
6
7
Personal Rights: "(a)...each client shall have personal rights which include, but are not limited to, the following: (7) Not to be locked in any room, building, or facility premises by day or night". This requirement is not met, as evidenced by:
1
2
3
4
5
6
7
The Program Manager informed that S2 has been terminated. Program Manager agreed to coordinate retraining for all staff on Personal Rights and staff burnout by an outside vendor. Proof of training will be provided to Community Care Licensing by the POC due date.
8
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12
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14
Based on records review and interviews, the Licensee did not allow 1 of 4 residents (R1) to not be locked into any room, building, or on facility premises. This posed a potential safety and personal rights risk to persons in care.
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9
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14
Type B
09/19/2023
Section Cited
CCR
80076(a)(2)
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2
3
4
5
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7
Food Services: "(a) In facilities providing meals to clients, the following shall apply: (2) Where all food is provided by the facility, arrangements shall be made so that each
client has available at least three meals per day." This requirement is not met as evidenced by:
1
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7
Program Manager agreed to coordinate retraining for all staff on 80076 Food Services and submit proof of training to Community Care Licensing by the POC due date.
8
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14
Based on records review and interviews, Licensee did not arrange for 1 of 4 clients (R1) to have at least 3 meals per day. This posed a potential safety and personal rights risk to persons in care.
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14
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: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 6
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
06/15/2023 and conducted by Evaluator Nacole Patterson
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20230615100058

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:
09/19/2023
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Monica McDade, Program ManagerTIME COMPLETED:
12:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff pushed resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Nacole Patterson and LPM Lizzette Tellez conducted an unannounced visit to deliver findings regarding the above complaint allegation. LPA introduced herself and disclosed the purpose of the visit to Monica McDade, Program Manager.

On 6/15/23 it was alleged that that facility staff pushed a resident. The Department’s investigation consisted of unannounced facility visits, review of facility and outside source records, interviews with facility staff, residents, outside sources, and LPA direct observations.

It was alleged that a staff member pushed Resident 1 (R1). Resident and staff interviews did not corroborate that staff pushed or physically touched a resident in a way that indicated intent to harm. Outside sources interviewed did not offer evidence or observation of staff pushing a resident. Upon interview, the resident in question (R1) denied that any staff member pushed them. No records were found to indicate that the incident occurred. (Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
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 6
Control Number 08-AS-20230615100058
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: EUBANK CASTLE
FACILITY NUMBER: 374603818
VISIT DATE: 09/19/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
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21
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32
(Continued from LIC9099)

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation(s) occurred, therefore the allegation is UNSUBSTANTIATED.  An exit interview was conducted with Monica McDade, Program Manager, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 08-AS-20230615100058
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: EUBANK CASTLE
FACILITY NUMBER: 374603818
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/19/2023
Section Cited
CCR
80072(a)(1)
1
2
3
4
5
6
7
Personal Rights: "(a)...each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons." This requirement is not met, as evidenced by:
1
2
3
4
5
6
7
The Program Manager informed that S1 and S2 have been terminated. Program Manager agreed to coordinate retraining for all staff on Personal Rights and staff burnout by an outside vendor. Proof of training will be provided to Community Care Licensing by the POC due date.
8
9
10
11
12
13
14
Based on records review and interviews, Licensee did not accord 1 of 4 residents (R1) dignity in their personal relationships with staff. This posed a potential personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6