374604245-1-23-2024-08-AS-DPOL-CZY2ST-20240129163940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604245
Report Date: 01/23/2024
Date Signed: 01/23/2024 02:16:03 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
07/17/2023 and conducted by Evaluator Renita Hall

COMPLAINT CONTROL NUMBER: 08-AS-20230717124051

FACILITY NAME:	CHLOE'S HOME		FACILITY NUMBER:	374604245
ADMINISTRATOR:	ENGAY, ERWIN		FACILITY TYPE:	735
ADDRESS:	228 CARTER STREET		TELEPHONE:	(619) 995-8874
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY:	4	CENSUS: 4	DATE:	01/23/2024
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Bienvenido Longalong, Carevier		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff are not providing adequate supervision over residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to deliver findings regarding the above-mentioned allegation. LPA was allowed entry by Bienvenido Longalong, Caregiver. LPA identified herself and disclosed the purpose of the visit and elements of the findings with the Caregiver

On July 17, 2023, an allegation was made regarding staff members not providing adequate supervision over residents in care at Chloe's Home.

The Reporting Party (RP) claimed that staff members at Chloe's Home were not adequately supervising residents, potentially compromising their safety and well-being. The allegation specifically mentioned that a resident made a verbal threat to them and their children when they were on their property. RP stated that Resident 1 (R1) made the alleged verbal threats "I will kill you" and "weak" in a language other than English which the RP does not speak or understand.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

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-20230717124051

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: CHLOE'S HOME	FACILITY NUMBER: 374604245
	VISIT DATE: 01/23/2024

NARRATIVE

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RP did not know if the language was Spanish or Tagalog. RP stated that there was no physical contact and that R1 was not on their property when the alleged threat was made. RP stated that R1 was getting out of a vehicle with a staff member. RP stated that they wanted the resident to be evicted.

Interviews were conducted and relevant documentation, including incident reports, and staff schedules, were reviewed to identify any patterns or discrepancies. Staff schedules demonstrated adequate coverage and allocation of staff members to ensure supervision over residents at all times.

Based on the investigation findings, it is concluded that the allegation of staff members not providing adequate supervision over residents in care at Chloe's Home is unsubstantiated. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Bienvendio Longalong, Caregiver; a copy of this report along with Licensee Appeal Rights LIC 9058 (REV 3/22) were provided to the Caregiver and his signature confirms receipt of these document

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

LIC9099 (FAS) - (06/04)

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