<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604245
Report Date: 09/15/2022
Date Signed: 09/15/2022 03:11:52 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
09/12/2022 and conducted by Evaluator Elizabeth Hamilton
COMPLAINT CONTROL NUMBER: 08-AS-20220912100213
FACILITY NAME:CHLOE'S HOMEFACILITY NUMBER:
374604245
ADMINISTRATOR:ENGAY, ERWINFACILITY TYPE:
735
ADDRESS:228 CARTER STREETTELEPHONE:
(619) 995-8874
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:4CENSUS: 4DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Licensee, Erwin EngayTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unlawful Eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced complaint investigation visit at the facility for the above allegation. LPA was greeted at the front entrance by Licensee, Erwin Engay and granted entry after identifying herself. LPA explained the purpose of the visit with Licensee, Engay and Administrator, Don Longolong and reviewed the basic elements of the complaint.

During today’s visit, LPA requested and reviewed client, staff and facility records, interviewed Licensee, Erwin Engagy and outside sources and briefly toured the facility. LPA also observed client 1 (C1 see confidential names list LIC 811) at the facility. LPA determined investigative findings and delivered findings to Licensee.

On September 12, 2022, it was alleged that on September 11, 2022, C1 was unlawfully evicted from the facility after a hospital stay. On September 10, 2022, C1 was admitted to the hospital and on September 11, 2022 was ready to be discharged; it was alleged however, the Administrator would not accept C1 back at the facility due to safety concerns about C1’s behaviors.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
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-20220912100213
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: CHLOE'S HOME
FACILITY NUMBER: 374604245
VISIT DATE: 09/15/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Interviews with Licensee and outside sources determined that although C1 was evaluated as ready for discharge on September 11, 2022, C1 returned to the facility the next day on September 12, 2022. Records reviewed confirmed that C1 was discharged from the hospital on September 12, 2022. There was insufficient evidence to support the allegation of unlawful eviction since the client had returned.

The Department has investigated the allegation listed above. Based on evidence obtained, including interviews and records reviewed, the above allegation is determined to be unsubstantiated as the Department could not meet the preponderance of the evidence standard. An exit interview was conducted with Licensee, Engay and a copy of this report, LIC 811 and Licensee/Appeals Rights (LIC 9058 01/16) was provided.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2