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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604057
Report Date: 07/16/2025
Date Signed: 07/16/2025 04:53:47 PM

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
09/07/2021 and conducted by Evaluator Donna Teutschel
COMPLAINT CONTROL NUMBER: 08-AS-20210907140754
FACILITY NAME:ELMCROFT OF LA MESAFACILITY NUMBER:
374604057
ADMINISTRATOR:HEBNER, WESFACILITY TYPE:
740
ADDRESS:4960 MILLS STREETTELEPHONE:
(619) 644-1100
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:0CENSUS: DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
04:45 PM
MET WITH:Unavailable/Facility ClosedTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff handled resident in a rough manner.
Staff did not report incident to resident's responsible party in a timely manner.
INVESTIGATION FINDINGS:
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LPMII RA, Donna Teutschel, conducted a review of the complaint information gathered to date. Facility was closed on 6/7/23. Insufficient statements or records obtained and the Department is unable to prove or disprove the above allegations. Complaint findings are deemed Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stacy Barlow
LICENSING EVALUATOR NAME: Donna Teutschel
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
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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