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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374603890
Report Date: 12/23/2022
Date Signed: 12/23/2022 12:46:21 PM

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
11/01/2021 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20211101094025
FACILITY NAME:TRINITY CARE HOMESFACILITY NUMBER:
374603890
ADMINISTRATOR:YARINN GONZALEZFACILITY TYPE:
735
ADDRESS:104 COLBERT DRIVETELEPHONE:
(619) 750-7663
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:4CENSUS: 4DATE:
12/23/2022
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Yarinn Gonzalez, AdministratorTIME COMPLETED:
11:35 AM
ALLEGATION(S):
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Provider was verbally aggressive to resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to deliver findings on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Yarinn Gonzalez, Administrator to discuss the purpose of the visit.

LPA conducted the initial investigation visit on November 5, 2021 and conducted interviews, made observations, and obtained and reviewed pertinent records. It was alleged that provider was verbally aggressive to resident. Interviews revealed that on or around October 29, 2021 staff and San Diego Regional Center staff were on a three way call with Client 1 (C1) and interviews with outside source revealed that the provider became verbally aggressive and confrontational with the C1. Interviews with outside sources thinks the way the provider conducted themselves was verbally abusive.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2022
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 2
Control Number 08-AS-20211101094025
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: TRINITY CARE HOMES
FACILITY NUMBER: 374603890
VISIT DATE: 12/23/2022
NARRATIVE
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Interviews with clients revealed that the provider is supportive and nice. They did not report that the provider is aggressive at any time. Interviews with another outside source revealed that the provider is always available and helpful. They are always with the clients and the clients admire and respect the providers. They also did not corroborate that the provider is verbally abusive. Interview with Staff revealed staff denied allegation of being verbally abusive. The allegation is unsubstantiated. An exit interview was conducted with Yarinn Gonzalez and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2