374604139-12-30-2022-08-AS-SJAB-CMLUSS-20221230145048

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604139
Report Date: 12/30/2022
Date Signed: 12/30/2022 01:53:20 PM

Unsubstantiated

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
05/04/2021 and conducted by Evaluator Debbie Correia

COMPLAINT CONTROL NUMBER: 08-AS-20210504125737

FACILITY NAME:	A LOVING HOME		FACILITY NUMBER:	374604139
ADMINISTRATOR:	JONES, DARIO S		FACILITY TYPE:	735
ADDRESS:	6208 LAKE ATHABASKA PL		TELEPHONE:	(619) 825-8256
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92119
CAPACITY:	4	CENSUS: 3	DATE:	12/30/2022
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Licensee Dario Jones		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Client not accorded privacy.
Staff speak inappropriately to client in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to deliver findings regarding the above listed complaint allegations. LPA identified herself to DSP Jason Fleck and Licensee Dario Jones to whom was explained the purpose of the visit.

The department’s investigation consisted of staff, client, and outside source interviews. The investigation also included facility, and outside source records review and a facility tour.

It was alleged that a Client1 (C1) [See LIC 811 Confidential Names List] was not afforded privacy. A facility record review revealed C1 was admitted to the facility on December 4, 2019. At the time of admission C1 was 19 years old and diagnosed with Intellectual Functional Disability. A review of Outside source records revealed C1 had a history of behaviors when not getting what they wanted. Records revealed C1 would become very difficult, defiant, and have verbal outbursts. An interview with C1 revealed they were angry about not being able to come and go from the facility whenever they pleased, and they were not allowed to do their own laundry.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 12/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2022

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-20210504125737

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: A LOVING HOME	FACILITY NUMBER: 374604139
	VISIT DATE: 12/30/2022

NARRATIVE

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Interviews conducted with Facility Staff1 (S1) and Staff2 (S2) revealed C1 does not follow house rules and clients are not allowed to do their own laundry unassisted. Staff interviews and a facility tour also revealed the laundry room remains locked due to the toxins that are kept in the laundry room, per Title 22 regulation. Outside source records also revealed C1 was not allowed to leave the facility unassisted except for attending school. Outside Source (OS1 and OS2) interviews revealed C1 does not recognize their disability and feels they should be able to do whatever they want making placement for C1 difficult. C1 also refuses to attend doctor appointments, including a psychiatrist for an evaluation.

It was also alleged facility staff speak inappropriately to clients in care. Interviews with conducted with facility staff, an outside source, and a Client2 (C2) revealed no evidence supporting the allegation. A record review also revealed C1 was threatening to file a complaint. At the time of the complaint C1 was angry after facility staff notified them if they continued to break house rules, they would have to seek alternative placement.
Based on LPA’s observations, records review, and interviews conducted with clients, staff, and outside sources the above allegation was determined to be unsubstantiated. An unsubstantiated finding means although the allegation may have occurred the preponderance of the evidence standard has not been met.

An exit interview was conducted with Licensee Jones and a copy of this report along with Licensee/Appeal Rights (LIC 9058 01/16) will be provided . Signature of this form confirms receipt the documents were received.

SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:	DATE: 12/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2022

LIC9099 (FAS) - (06/04)

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