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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604282
Report Date: 02/03/2025
Date Signed: 02/03/2025 12:35:21 PM

Substantiated


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
01/29/2025 and conducted by Evaluator Amy Rodgers
COMPLAINT CONTROL NUMBER: 08-AS-20250129155517
FACILITY NAME:ABIGAIL'S HOMES IIIFACILITY NUMBER:
374604282
ADMINISTRATOR:GONZALEZ, BRENDA ABIGAILFACILITY TYPE:
735
ADDRESS:2505 ARCADIA AVETELEPHONE:
(619) 439-7791
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:4CENSUS: 2DATE:
02/03/2025
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Assistant Administrator Raquel GarciaTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility staff do not provide sufficient meals to clients
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA's) Amy Rodgers and Arian Golbakhsh conducted an unannounced complaint visit initiate an investigation on the above-mentioned allegations. LPA met with Assistant Administrator Raquel Garcia and discussed the basic elements of the complaint.

On January 29, 2025, Community Care Licensing (CCL) received a complaint alleging staff did not provide Client 1 (C1) and Client 2 (C2) enough food for their lunch.

During investigation, LPAs collected pertinent client records, made observations, and conducted interviews.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025
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 08-AS-20250129155517
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: ABIGAIL'S HOMES III
FACILITY NUMBER: 374604282
VISIT DATE: 02/03/2025
NARRATIVE
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(Continued form 9099)

According to C1’s Physician’s Report dated May 9, 2024, C1 is diagnosed with Asperger's. However, the physicians reported dated July 15, 2020 lists a secondary diagnosis with Oppositional defiant disorder and obesity. C1 is occasionally able to follow instruction or has no problems following directions. Based on C1’s Individual Program Plan, C1 will receive staff support as necessary.

According to C2’s Physician’s Report dated August 23, 2024, C2 is diagnosed with Diabetes, schizophrenia tobacco use, asthma, and can be confused occasionally. The physicians reported dated September 6, 2022 states C2 is able to follow instruction with no problems.. Based on C2’s Individual Program Plan, C2 will receive staff support as necessary.

According to the allegation, between January 2024 and January 2025, with the exception of approximately 3 weeks in a row, C1 and C2 has been arriving to an outside program with less than enough food for a meal or with no meal.

Outside source interviews revealed that C1 and C2 have, on multiple occasions, arrived to program with either no lunches or less than enough food for a meal. LPA observed on 2/3/2025 C1's lunch to consist of only four (4) pieces of white bread and C2 to not have a lunch. Interview with staff revealed that C1 and C2 make their own lunch with minimal staff assistance.

Based on interviews, observations and records reviewed, a preponderance of evidence exists to support the allegations. Deficiencies are being cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Assistant Administrator Raquel Garcia, to whom a copy of this report, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20250129155517
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: ABIGAIL'S HOMES III
FACILITY NUMBER: 374604282
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/03/2025
Section Cited
CCR
80076(a)(1)
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Food Service (a) in all facilities providing meals to clients (1)all food shall be...of the quality and in the quantity necessary to meet the needs of the clients. Each meal shall meet at least 1/3 of the servings recommeded in the USDA food plan.
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Licensee agrees to change options on daily food menu to meet the needs of C1's and C2's diet. Licensee agrees to prepare or help prepare breakfast and lunches and provide training to caregivers on assisting C1 and C2 with food choices.
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This requirement was not met as evidenced by: Based on interviews and observations the licensee did not provide meals in the quality or quantity necessary to meet the needs of the clients in 2 of 2 persons in care ([C1 and C2]) which posed a potential Health risk to persons in care.
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Licensee will provide proof of a daily log of itemized food in the packed lunches and training to LPA by due date.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3