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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604269
Report Date: 05/09/2024
Date Signed: 05/09/2024 10:20:45 AM

Unfounded


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
05/08/2024 and conducted by Evaluator Javina George
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240508093535
FACILITY NAME:FELICITA VIDAFACILITY NUMBER:
374604269
ADMINISTRATOR:MALASPINA, KIMBERLYFACILITY TYPE:
740
ADDRESS:930 MONTICELLO DRIVETELEPHONE:
(760) 747-4888
CITY:ESCONDIDOSTATE: CAZIP CODE:
92029
CAPACITY:123CENSUS: 87DATE:
05/09/2024
UNANNOUNCEDTIME BEGAN:
08:56 AM
MET WITH:Kimberly Malaspina, Executive DirectorTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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9
Uncleared adult is working at the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation in regards to the allegation noted above. LPA met with Executive Director Kimberly Malaspina and explained the purpose of the visit and elements of the allegation. The allegation was investigated and the investigation consisted of observations, interviews, records review.

On 05/08/24 Community Care Licensing received a complaint alleging that an uncleared adult was working at the facility specifically Staff #1 (S1). LPA conducted a review of the staff schedule and reviewed a payroll report which confirmed that S1 is actively working at the facility.

LPA conducted a personnel inquiry in the Licensing Information System (LIS), which revealed that S1 was eligible for criminal record clearance effective 3/1/24. LPA further observed for S1 to have been associated to the facility since 3/1/24 and a second entry on 3/5/24. A review of S1s employee file revealed the proper steps were taken to obtain criminal record clearance such as having completed a live scan (fingerprints).
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
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 18-AS-20240508093535
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: FELICITA VIDA
FACILITY NUMBER: 374604269
VISIT DATE: 05/09/2024
NARRATIVE
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Based on observations, interviews and records review the allegation of uncleared adult is working at the facility is unfounded. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was reviewed and provided to Executive Director Kimberly Malaspina.
SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2