374604285-4-6-2023-08-AS-LTEZ-CQTTGB-20230412144252

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604285
Report Date: 04/06/2023
Date Signed: 04/06/2023 12:25:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/28/2023 and conducted by Evaluator Dawn Segura

COMPLAINT CONTROL NUMBER: 08-AS-20230328134417

FACILITY NAME:	ANGELS HAVEN 3		FACILITY NUMBER:	374604285
ADMINISTRATOR:	FRENCH, CHRISTINE		FACILITY TYPE:	735
ADDRESS:	1094 MERIDIEN CT		TELEPHONE:	(760) 791-3955
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92057
CAPACITY:	4	CENSUS: 3	DATE:	04/06/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Rowena Carlos, Staff		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility installed a locked gate without prior approval for secured perimeter.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced visit to commence a complaint investigation into the above listed allegation. LPA introduced herself, was granted entry, and met with Rowena Carlos, Staff, to whom she disclosed the purpose of the visit. LPA spoke with Christine French, Licensee, via telephone, at the start of the visit.

Community Care Licensing (CCL) has investigated the above listed complaint allegation. The investigation consisted of a tour of the property, inside and out, records review, and interview of licensee and staff. During the record review and tour of the property grounds, LPA learned and observed that an iron gate had been installed at the front of the home in January 2023. Interviews yielded that the gate was installed to serve as a visual deterrent in an effort to prevent a client who requires supervision while out in the community from leaving the premises without supervision. During the visit, LPA observed that there is a self-latching mechanism at the top of the gate and a lock near the gate handle. LPA observed the lock to be one that did not require a key from the inside and could easily be opened from the inside by simply turning the lock to the

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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-20230328134417

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ANGELS HAVEN 3	FACILITY NUMBER: 374604285
	VISIT DATE: 04/06/2023

NARRATIVE

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open position. The self-latching mechanism was able to be easily opened, and LPA did not see or obtain any information that indicated that a lock was used to secure the mechanism. LPA was able to easily open both devices from inside and outside the gate to gain access to and exit from the facility’s courtyard. The investigation did not yield evidence to conclude that the gate was locked from the inside, which would prevent clients from having easy egress.

Based upon a lack of evidence to corroborate the allegation, the allegation is unsubstantiated. This finding means that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Christine French, via telephone, and copies of this report and Licensee Rights were provided to Rowena Carlos at the conclusion of the visit. Her signature on this report acknowledges receipt of copies of the report and the rights.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dawn Segura
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC9099 (FAS) - (06/04)

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