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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 03:03:49 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
06/06/2023 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20230606225828
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:
01:18 PM
MET WITH:Raquel Garcia, AdministratorTIME COMPLETED:
01:55 PM
ALLEGATION(S):
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Staff physically 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 Raquel Garcia, Administrator 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 physically abused client . Interviews revealed Client 1 (C1) came home from program after having a rough day. Interviews revealed Client 1 (C1) went straight to their room after arriving to the facility. Interviews revealed Staff 1 (S1) called them 3 different times and C1 finally answered. Interviews revealed when staff walked in the room they exchanged words and C1 hit S1. S1 backed away from C1 and then C1 started to tussle with S1.
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 5
Control Number 08-AS-20230606225828
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 with S1 revealed that after C1 hit them again they fell to the floor and pushed C1 off of them. At that point interviews revealed S1 hit C1 to make C1 get off of them. S1 admitted to hitting C1 twice in the chest and in the arm but not in the face. Interviews revealed that C1 was upset about their cell phone and called their social worker from the facility phone.

Interviews revealed that S1 was not interviewed thoroughly by staff after the incident. S1 did not admit to the administrator that they hit C1.

Based on the evidence obtained from interviews, records review, 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 5
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
06/06/2023 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20230606225828

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:
01:18 PM
MET WITH:Raquel Garcia, AdministratorTIME COMPLETED:
01:55 PM
ALLEGATION(S):
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2
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9
Staff deprived client from own personal property
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 Raquel Garcia, Administrator to discuss the purpose of the visit.

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 deprived client from own personal property . Interviews revealed Client 1 (C1) came home from program after having a rough day. Interviews revealed (C1) went straight to their room after arriving to the facility. Interviews revealed (C1) did not where their phone was and suspected Staff 1 (S1) took it. C1 questioned S1 about their phone and S1 told them they did not have it.
Unsubstantiated
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: 4 of 5
Control Number 08-AS-20230606225828
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 after C1 called their social worker from the house phone that they did not know where their phone was. Interviews with S1 revealed after the incident the client was taken by the Sheriffs and did not know where C1s phone was.
Interviews with Administrator revealed they did not know where the phone was at the time either. During investigation the LPA observed the administrator conduct a search for the phone with no finding of the phone.

Based on the evidence obtained from interviews, the above-mentioned allegation is unsubstantiated.

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: 5 of 5
Control Number 08-AS-20230606225828
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)(3)
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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:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. 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 Personal Rights/ How to de-escalate clients and staff 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 admitted to physically abusing C1 by hitting them. 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 5