374604250-4-9-2026-18-AS-RORN-DT4UAV-20260413152522

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604250
Report Date: 04/09/2026
Date Signed: 04/09/2026 11:13:11 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/11/2024 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 18-AS-20240911143709

FACILITY NAME:	BUILDING INDEPENDENCE 1		FACILITY NUMBER:	374604250
ADMINISTRATOR:	SANCHEZ, JAQUELINE		FACILITY TYPE:	735
ADDRESS:	1965 PIZARRO LANE		TELEPHONE:	(858) 780-6695
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92026
CAPACITY:	4	CENSUS: 3	DATE:	04/09/2026
		UNANNOUNCED	TIME BEGAN:	08:22 AM
MET WITH:	Sanchez Jaqueline		TIME COMPLETED:	11:23 AM

ALLEGATION(S):

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Staff did not take resident to scheduled medical appointment.

INVESTIGATION FINDINGS:

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On April 9, 2026, the California Department of Social Services/Community Care Licensing (CDSS/CCL) Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced follow-up visit regarding a complaint. The LPA met with the staff, Pablo Cabrera, and explained that the purpose of the visit was to investigate the complaint allegation mentioned above. Later, LPA was joined by the Administrator, Sanchez Jaqueline.
The investigation involved collecting records and conducting interviews. The department obtained various documents, including the Personnel Report LIC 500 (dated 04/09/26) and the Client Roster (dated 04/09/26). The department reviewed and gathered all records for Client C1, such as the Admission Agreement (dated 12/03/23), Face sheet, Physician Report (dated 07/03/24), Consent for Surgery dated 09/12/24, unusual incident report, dated 09/11/24, Whole Person Assessment dated 09/12/24, and the department interviewed the Administrator (A1), one staff member (S1), and three clients (C2-C4). The department was unable to interview Client #1 (C1) because C1 no longer resides at the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

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 18-AS-20240911143709

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: BUILDING INDEPENDENCE 1	FACILITY NUMBER: 374604250
	VISIT DATE: 04/09/2026

NARRATIVE

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Allegation #1: Staff did not take residents to scheduled medical appointments.

The complaint alleged that the client missed a podiatry appointment on September 11, 2024. On April 9, 2026, the department interviewed the Administrator (A1), who denied the allegation. A1 explained that on the day of the appointment, the client exhibited aggressive behavior, verbally abused staff, and refused to get into the car. The facility made efforts to de-escalate the situation. During this time, the podiatrist called about the appointment, and we explained that we needed to reschedule because the client's behavior prevented us from taking C1. A1 also noted that the client has transportation issues and had been expelled from the day program due to safety concerns during vehicle travel. Additionally, A1 stated that the facility took the client to the rescheduled appointment on September 12, 2024.

On the same day, the department interviewed one staff member (S1), who confirmed that the client (C1) is very aggressive, has hit staff, and does not remain seated in the vehicle with the seat belt on. The department also interviewed three other clients (C2-C4), all of whom stated that they enjoy living at the facility and that the staff takes them to all their appointments.

On April 9, 2026, the department reviewed the consent form for surgery dated September 12, 2024, which confirmed that the facility had rescheduled the client's appointment for the following day. The department also reviewed the Whole Person Assessment (WPA), which confirmed that C1 missed the appointment due to aggressive behavior toward staff. The department received a copy of the Unusual Incident Report submitted by the facility to the Community Care Licensing Department (CCLD) on September 11, 2024, regarding the incident that day. The department also received a copy of the recommendation from the Behavior consultant dated 09/13/24, which limited the client's outing due to behavior while traveling in a vehicle.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur; therefore, the Allegation is Unsubstantiated.

No deficiencies were cited.

An exit interview conducted. A copy of the report was provided to the Administrator, Jacqueline Sanchez.

SUPERVISORS NAME: Antonine Richard
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

LIC9099 (FAS) - (06/04)

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