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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604087
Report Date: 09/21/2023
Date Signed: 09/21/2023 12:24:38 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
08/31/2023 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20230831113109
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: 2DATE:
09/21/2023
UNANNOUNCEDTIME BEGAN:
11:41 AM
MET WITH:Katrina Russell, AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
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8
9
Client was not accorded dignity.
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit to close a complaint investigation regarding the above-mentioned allegation. LPA identified herself and met with Katrina Russel, Administrator to discuss the purpose of the visit and elements of the complaint.

It was alleged that the client was not accorded dignity. Interviews with clients revealed the clients all got along very well. One usually leaves and goes to program and when they come home are usually to themselves. There are two other clients that buy things for each other, trade and share many things. Interviews revealed the staff treat the clients with dignity and respect. Interviews revealed all clients treat each other with respect as well. Interviews revealed the staff are not aware that any threats have been made and clients are usually outspoken and will speak up if something like that would have happened. Interviews revealed that sometimes clients have disagreements with each other but there hasn't been any incidents in which the clients complained about any threats or any bullying to staff.

The allegation of client was not accorded dignity is unsubstantiated. An exit interview was conducted with Katrina Russell and a copy of this report and Licensee Appeal rights (LIC 9058 03/22) were provided at the conclusion of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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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