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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603828
Report Date: 09/22/2025
Date Signed: 09/22/2025 09:54:53 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRALIZED APP UNIT, 744 P STREET, MS 9-14-8201
SACRAMENTO, CA 95814
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/25/2023 and conducted by Evaluator Donna Teutschel
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20230725144135
FACILITY NAME:A PLACE OF GRACE INC CHASE AVENUEFACILITY NUMBER:
374603828
ADMINISTRATOR:SHANTA HAINESFACILITY TYPE:
735
ADDRESS:1144 E CHASE AVETELEPHONE:
(619) 631-7656
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:0CENSUS: DATE:
09/22/2025
UNANNOUNCEDTIME BEGAN:
08:38 AM
MET WITH:Facility Closed 11/18/24TIME COMPLETED:
10:00 AM
ALLEGATION(S):
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9
Staff neglect resulted in client becoming severly dehydrated
Staff do not follow clients prescribed special diet
INVESTIGATION FINDINGS:
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13
Facility closed 11/18/24. The Department's investigation revealed that this client was schizophrenic with autism epilepsy and demonstrated behavior disorders requiring a high level of supervision. The Department also conferred with consulting physician form Medical Fraud and Elder Abuse and the client's psychiatrist who both concurred that the dehydration was not severe but minor and felt it was due to a change in dosage of client's lithium medication which resulted in increased behaviors, hospitalization and the lithium medication was immediately adjusted by the psychiatrist. There was no evidence to support lack of compliance in client's diet.The Department cannot prove or disprove the above allegations. Complaint findings are deemed Inconclusive.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stacy Barlow
LICENSING EVALUATOR NAME: Donna Teutschel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2025
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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