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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604123
Report Date: 12/11/2024
Date Signed: 12/11/2024 11:14:49 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2024 and conducted by Evaluator Janette Romero
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20241104154900
FACILITY NAME:MERAKEY - WYNDEMEREFACILITY NUMBER:
374604123
ADMINISTRATOR:BUCKINGHAM, ADELITAFACILITY TYPE:
737
ADDRESS:26184 WYNDEMERE CTTELEPHONE:
(442) 286-7548
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:4CENSUS: 4DATE:
12/11/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Administrator, Adelita BuckinghamTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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Staff speaks inappropriately to client in care
INVESTIGATION FINDINGS:
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On 12/11/2024, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to deliver findings regarding an investigation into the allegation listed above. LPA met with Administrator, Adelita Buckingham who was informed of the purpose of the visit.

It was alleged Staff 1 (S1) stated to Client 1 (C1), “I’ll tie you up and send you back to the mental hospital if you hit me”. LPA reviewed C1’s Individual Program Plan dated 11/02/2022 noting C1 is able to speak in clear and complete sentences and communicate without issue. C1 was interviewed and corroborated the allegation but was unable to provide an estimated incident date or identify any possible witnesses. Administrator Buckingham was interviewed and reported on 10/30/2024 the facility received an email from Staff 2 (S2) reporting the allegation involving S1 and C1.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
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 18-AS-20241104154900
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: MERAKEY - WYNDEMERE
FACILITY NUMBER: 374604123
VISIT DATE: 12/11/2024
NARRATIVE
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LPA reviewed the email from S2 dated 10/30/2024, which did not specify an alleged incident date or time. LPA made several attempts to contact S1 and S2 but never received a response. LPA conducted a record review and noted S2 had the Department’s required training records and signed a Statement Acknowledging Requirement to Report Suspected Abuse of Dependent Adults and Elders (SOC 341A) which defines different forms of abuse. Three (3) additional clients were also interviewed and reported none of the facility staff have made inappropriate statements to them, and they have not witnessed staff make inappropriate statements to any of the other clients in the home. Three (3) additional staff were interviewed, and only (1) of three (3) staff reported witnessing S1 make a different inappropriate statement to C1 in the past. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is Unsubstantiated. An exit interview was conducted, and a copy of this report was reviewed and provided to Administrator Buckingham.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2