374604250-4-9-2026-18-AS-RORN-DT4TZY-20260413151108

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604250
Report Date: 04/09/2026
Date Signed: 04/09/2026 12:51:53 PM

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
04/26/2024 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 18-AS-20240426082736

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:	11:17 AM
MET WITH:	SANCHEZ JAQUELINE		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff abandoned resident at the hospital.

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 staff member Pablo Cabrera and explained that the purpose of the visit was to investigate the complaint allegation mentioned above. Later, the 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 06/01/25) and the Client Roster (dated 06/01/25). The department reviewed and gathered all records for Client C1, including 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 04/24/24), Whole Person Assessment (dated 09/12/24), and Client Discharged from Palomar Medical Center (dated 04/29/24). The department interviewed the Administrator (A1), one staff member (S1), and three clients (C2-C4). A copy of the 3-day eviction notice dated 12/05/24. 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)

Page: 1 of 3

Control Number 18-AS-20240426082736

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 abandoned the residents at the hospital.

The complaint alleged that law enforcement brought the client to the hospital under a 5150 hold. On April 9, 2026, the department interviewed the Administrator (A1), who denied the allegation. A1 explained that on April 24, 2024, the Community Integrated Program discontinued services for client #1 (C1) due to safety concerns. C1 had unbuckled their seat-belt while the vehicle was on the freeway. Also, C1 attempted to pinch the driver while driving.

When C1 arrived at the facility, C1 was very upset and aggressive, prompting a call to Emergency Services, who then transported C1 to the hospital under a 5150 hold. On April 25, 2024, the hospital contacted the facility to request that they pick up the client. Upon arrival at the hospital, C1 was extremely agitated and out of control. Due to this aggressive behavior, both towards the hospital staff and the facility staff, A1 decided to leave C1 at the hospital for further care, as the client was also medically and physically restrained. A1 noted that the facility continued to visit C1 throughout C1's hospital stay.

On April 29, 2024, C1 was deemed fit for discharge, and the facility picked C1 up from the hospital. On the same day, the department interviewed one staff member (S1), who confirmed that C1 is very aggressive, has physically assaulted staff members, and often does not remain seated with their seatbelt fastened in the vehicle. The department also spoke with 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.

The department also reviewed the Whole Person Assessment (WPA), which confirmed that the client had multiple 5150 holds due to aggressive behavior. The department received a copy of the Unusual Incident Report submitted by the facility to the Community Care Licensing Department (CCLD) on 04/24/24 regarding the incident that occurred 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.

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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Control Number 18-AS-20240426082736

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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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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