374604207-3-4-2026-08-AS-SMAZ-DSQLMV-20260401085318

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604207
Report Date: 03/04/2026
Date Signed: 03/04/2026 05:15:42 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
07/31/2025 and conducted by Evaluator Nacole Patterson

COMPLAINT CONTROL NUMBER: 08-AS-20250731173136

FACILITY NAME:	LIBERTY HARMONY		FACILITY NUMBER:	374604207
ADMINISTRATOR:	MANIPON, CHERIFER		FACILITY TYPE:	737
ADDRESS:	2915 DUCK POND LANE		TELEPHONE:	(760) 975-7176
CITY:	RAMONA	STATE: CA	ZIP CODE:	92065
CAPACITY:	4	CENSUS: 0	DATE:	03/04/2026
		UNANNOUNCED	TIME BEGAN:	05:01 PM
MET WITH:	Facility Closed. Report Mailed to Licensee's Last Known Address		TIME COMPLETED:	05:20 PM

ALLEGATION(S):

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Neglect/Lack of supervision resulting in injury.

INVESTIGATION FINDINGS:

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The following determination of findings have been made by Licensing Program Analyst (LPA) Nacole Patterson regarding the above complaint allegation. This report was mailed to the last known address for the Licensee.

On 07/31/25 it was alleged that staff neglect/lack of supervision resulted in injury to Client 1 (C1), specifically that scratches were observed on C1's back. The Department’s investigation consisted of an unannounced facility visit, interviews with facility staff, residents, outside sources, and records review.

Staff interviews revealed that C1 had sensitive skin which reacted with redness or marks even from benign actions such as intentionally scratching an itch. Staff informed that C1 had a tendency to fall out of chairs due to attempting to sit on the edge and needed reminders from staff to sit fully in the chair. Staff informed that daily body checks were logged for C1, as they did not have the capacity to vocalize when they had been injured. Staff informed that C1's care plan was followed with no issues pertaining to supervision. (Continued on LIC9099 p.2)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026

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-20250731173136

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: LIBERTY HARMONY	FACILITY NUMBER: 374604207
	VISIT DATE: 03/04/2026

NARRATIVE

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(Continued from LIC9099 p.1)

Interview with C1 was attempted, however, C1 was not able to be interviewed due to being outside of baseline during the facility visit.

Interview was conducted with an outside source familiar with the facility and C1. The outside source did not have concerns regarding staff supervision. The outside source informed that they have had numerous direct observations of the client and had not observed any unexplained marks or bruises.

Records review revealed that the facility reported an unusual incident on 07/20/2025 where C1 fell out of a dining room chair due to sitting on the edge. The report stated that C1 was being supervised at the time per care plan and was assessed for injuries after the event. C1's assessment records showed that C1 experienced confusion and was a fall risk, which was mitigated with interventions such as staff being 1:1 with C1 and assisting with Activities of Daily Living (ADLs). C1's records further showed that they were receiving medication that may have led to skin issues such as bruising easily or excessive redness and dry skin.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. This report and the Licensee/Appeal Rights (LIC9058 03/22) were mailed to the last known Licensee address.

SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Nacole Patterson
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2026

LIC9099 (FAS) - (06/04)

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