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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604087
Report Date: 05/12/2022
Date Signed: 05/13/2022 08:03:18 AM

Substantiated


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
05/03/2022 and conducted by Evaluator Liliana Silveira
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20220503165605
FACILITY NAME:MOUNTAIN VIEW HOME-DEL VISTA WAYFACILITY NUMBER:
374604087
ADMINISTRATOR:RUSSELL, KATRINAFACILITY TYPE:
735
ADDRESS:16350 DEL VISTA WAYTELEPHONE:
(619) 419-9938
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:4CENSUS: 3DATE:
05/12/2022
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Administrator Katrina RussellTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Unlawful eviction.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced complaint visit to investigate the above-mentioned allegation. LPA was met by Licensee/Administrator, Katrina Russell, and discussed the purpose of the visit.

Client #1 (C1) went to the hospital on May 2, 2022 and was to be released on May 3, 2022. The facility had requested approval from CCLD to serve a 3-day eviction to Client #1 (C1) on May 3, 2022, which was denied by Regional Manager Icela Estrada. The facility also submitted a copy of a 30-day eviction notice for C1 to CCLD on May 4, 2022. When it was time for the client to be released, the facility refused to allow the client back into the home.

Outside sources confirmed the client was refused return by the facility Administrator. The Administrator also admitted that she refused to accept the client back due to the client needing a higher level of care. The client always has the right to return to their home.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022
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 3
Control Number 08-AS-20220503165605
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: MOUNTAIN VIEW HOME-DEL VISTA WAY
FACILITY NUMBER: 374604087
VISIT DATE: 05/12/2022
NARRATIVE
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There is sufficient evidence to determine an unlawful eviction. The preponderance of the evidence standard has been met, therefore, the above-mentioned allegation is substantiated. The violation is cited in accordance with California Code of Regulations, Title 22, and is recorded on the attached 9099-D (Deficiency) Page.

An exit interview was conducted with Administrator, Katrina Russell, and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) was provided to Katrina at the facility.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20220503165605
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: MOUNTAIN VIEW HOME-DEL VISTA WAY
FACILITY NUMBER: 374604087
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/12/2022
Section Cited
CCR
80068.5(b)
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80068.5 Eviction Procedures (b) The licensee shall obtain prior written approval from the Department to evict the client upon three (3) days written notice to quit and upon a finding of good cause.
This requirement was not met as evidenced by:
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Licensee refuses to take client back.Licensee will complete training through an authorized vendor on Title 22 Regulations. Licensee agreed to complete training by 07/12/22. Licensee will also follow CCR Title 22 admissions procedures when admitting new clients.
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The three (3) days written notice to quit was denied by the Department. Based on interviews, the licensee did not allow C1 to return to the facility. This posed an immediate personal rights risk to 1 of the 4 clients in care.
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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: Denise Powell
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3