374603896-5-22-2025-08-AS-SJAB-DH4PCQ-20250528111218

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603896
Report Date: 05/22/2025
Date Signed: 05/22/2025 02:59:02 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
03/06/2025 and conducted by Evaluator Angelica Boyles

COMPLAINT CONTROL NUMBER: 08-AS-20250306135457

FACILITY NAME:	RUSSELL HOMES MANOR		FACILITY NUMBER:	374603896
ADMINISTRATOR:	WAINSCOTT, ANGELIA		FACILITY TYPE:	735
ADDRESS:	1146 SUMNER AVE		TELEPHONE:	(619) 749-0704
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY:	6	CENSUS: 4	DATE:	05/22/2025
		UNANNOUNCED	TIME BEGAN:	01:46 PM
MET WITH:	Krista Duvall - Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Licensee did not ensure the facility is free of pests & rodents
Licensee did not ensure pathways were kept free of hazards and obstructions

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Boyles conducted an unannounced visit to the facility to deliver investigative findings regarding the above mentioned allegations. LPA identified herself, explained the purpose of the visit and nature of the complaint to Administrator Krista Duvall.

The allegations that licensee did not ensure the facility is free of pests and rodents and licensee did not ensure pathways were kept free of hazards and obstructions were based on a Quality Assurance Evaluation for compliance with Title 17 regulations, conducted by the San Diego Regional Center (SDRC) on February 13, 2025. A Quality Assurance Report was sent to The Department by SDRC and received on March 6, 2025. The Department's investigation into these allegations consisted of observations, interviews, and a records review.

(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

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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Control Number 08-AS-20250306135457

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: RUSSELL HOMES MANOR	FACILITY NUMBER: 374603896
	VISIT DATE: 05/22/2025

NARRATIVE

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(Continued from LIC9099)

Regarding the allegation that licensee did not ensure the facility is free of pests and rodents, facility staff provided documentation that showed the facility has regularly scheduled pest control services. Interview with staff and clients revealed no witnesses of rodents or pests. Additionally, LPA did not observe anything indicative of there being pests or rodents.

Based on LPA’s observations, records reviewed, and interviews there was insufficient corroborating evidence to support that the licensee did not ensure the facility is free of pests and rodents. Therefore, the allegation is unsubstantiated.

Regarding the allegation that licensee did not ensure pathways were kept free of hazards and obstructions LPA did not observe anything obstructing pathways. LPA observed the door between the common area of dining area and the rear patio with a doorknob that is unable to lock on either side. Further, facility staff stated that this door is always propped open. LPA observed rear patio to be free of boxes or any tripping hazards. LPA observed rear door accessible to clients.

Based on LPA’s observations and interviews there was insufficient corroborating evidence to support that the licensee did not ensure the facility is free of pests and rodents. Therefore, the allegation is unsubstantiated.

An exit interview was conducted with Administrator Krista Duvall, to whom a copy of this report and the Licensee’s Rights (LIC9058 01/16) were provided.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

LIC9099 (FAS) - (06/04)

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