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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604232
Report Date: 03/28/2023
Date Signed: 03/28/2023 10:37:37 AM

Unfounded


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
03/23/2023 and conducted by Evaluator Carmen Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20230323111205
FACILITY NAME:REMINGTON CLUB IIFACILITY NUMBER:
374604232
ADMINISTRATOR:TERRI BOSTIANFACILITY TYPE:
740
ADDRESS:16922 HIERBA DRIVETELEPHONE:
(858) 673-6333
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY:140CENSUS: 62DATE:
03/28/2023
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Terri Bostian, Assistent Executive DirectorTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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- Facility did not keep indoor passageway free from obstruction.
- Staff did not ensure premises was maintained to provide healthful environment.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to open a complaint investigation. While at the facility LPA investigated and delivered findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Amatourahm “Alma” Bileh, Receptionist. LPA stated the purpose of the visit and reviewed the findings of the complaint with Raquel Mathews, Licensed Vocational Nurse (LVN) and Terri Bostian, Assistant Executive Director.

The Department’s investigation consisted of a tour of the facility, interviews with staff and an outside source, records reviewed of relevant documents pertinent to this investigation, and LPA observations of the facility grounds. On March 23, 2023, it was alleged that the facility did not keep indoor passageways free from obstruction; and staff did not ensure premises was maintained to provide a healthful environment.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen LopezTELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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 2
Control Number 08-AS-20230323111205
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: REMINGTON CLUB II
FACILITY NUMBER: 374604232
VISIT DATE: 03/28/2023
NARRATIVE
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Based on the Department’s investigation of the above-mentioned allegations and the evidence obtained during staff and an outside source interviews, records reviewed, and LPA observations we have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. The allegations were not pertinent to this licensed facility. The Department will be cross reporting this complaint to the appropriate agency for follow-up.

The report was discussed, and an exit interview was conducted with Terri Bostian, Assistant Executive Director. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) was provided to Assistant Executive Director Bostian at the conclusion of the visit. The signature below confirms the receipt of these documents.
SUPERVISOR'S NAME: Rebecca HedgecockTELEPHONE: (619) 767-2329
LICENSING EVALUATOR NAME: Carmen LopezTELEPHONE: (619) 314-0757
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2