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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604148
Report Date: 07/28/2023
Date Signed: 07/28/2023 03:04:35 PM

Substantiated


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
06/07/2023 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20230607164317
FACILITY NAME:ABIGAIL'S HOMES IIFACILITY NUMBER:
374604148
ADMINISTRATOR:GONZALEZ, BRENDA ABIGAILFACILITY TYPE:
735
ADDRESS:8738 VALENCIA STTELEPHONE:
(619) 315-7407
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:4CENSUS: 1DATE:
07/28/2023
UNANNOUNCEDTIME BEGAN:
12:54 PM
MET WITH:Raquel Garcia, AdministratorTIME COMPLETED:
01:17 PM
ALLEGATION(S):
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Staff verbally abused client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to deliver findings on the above-mentioned allegation. LPA gained access to the facility, identified herself, and met with Staff to discuss the purpose of the visit. LPA’s visit consisted of delivering findings on the above-mentioned allegation.

LPA conducted a physical inspection of the facility, collected relevant records, and conducted interviews with clients, facility staff, and outside sources. It was alleged that staff verbally abused client . Interviews revealed Client 1 (C1) was on the house phone speaking with their case worker when Staff 1 (S1) made a comment to C1 stating "Bitch I hit you back because you hit me first". Interviews revealed that the caseworker overheard the staff make the comment to C1 and S1 admitted to LPA during interview that they did make the comment and verbally abused C1.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
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-20230607164317
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ABIGAIL'S HOMES II
FACILITY NUMBER: 374604148
VISIT DATE: 07/28/2023
NARRATIVE
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Interviews revealed that S1 was upset about C1 hitting them and made the comment after C1 said something to the case worker.

Based on the evidence obtained from interviews, the above-mentioned allegation is substantiated. The allegation is valid because the preponderance of the evidence standard has been met. California code of Regulations, Title 22, Division 6 & Chapter 1 is being cited on the attached LIC 9099D.

An exit interview was conducted with Raquel Garcia, Administrator and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20230607164317
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ABIGAIL'S HOMES II
FACILITY NUMBER: 374604148
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/11/2023
Section Cited
CCR
80072(a)(1)
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Personal Rights (a)Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(1) To be accorded dignity in his/her personal relationships with staff and other persons.This requirment is not met as evidenced by:
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Licensee terminated S1 on 06/19/2023. Licensee will provide training for all staff on How to handle clients with challenging behaviors by an outside source. Licensee will provide LPA with training documents and sign in sheet by POC of 08/11/2023
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On 06/05/2023 S1 was overheard being verbally abusive to C1. S1 admitted to verbally abusing C1. This poses an immediate safety risk to 1 of 2 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: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3