<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604344
Report Date: 02/11/2025
Date Signed: 02/11/2025 09:46:21 PM

Unsubstantiated


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
02/04/2025 and conducted by Evaluator Amy Rodgers
COMPLAINT CONTROL NUMBER: 08-AS-20250204134023
FACILITY NAME:JIMENEZ HOMES ARF LLCFACILITY NUMBER:
374604344
ADMINISTRATOR:JIMENEZ, ERICKA D.FACILITY TYPE:
735
ADDRESS:1707 SKYLINE DRIVETELEPHONE:
(619) 987-2558
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:4CENSUS: 4DATE:
02/11/2025
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Licensee Ericka JimenezTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is refusing to accept resident back after hospital stay
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to open a complaint and deliver findings. LPA was allowed entry by Ericka Jimenez, Licensee. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Licensee.

The Department investigated the above-listed complaint allegations. The investigation consisted of a tour of the facility, multiple interviews with staff, outside sources, and records review.

On February 4, 2025, Community Care Licensing (CCL) received a complaint alleging an unlawful eviction to Client #1 (C1). It was specifically alleged that on February 4, 2025 Licensee stated the they could not accommodate C1 and refused to accept C1 back into the facility.

(continued on 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
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 2
Control Number 08-AS-20250204134023
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: JIMENEZ HOMES ARF LLC
FACILITY NUMBER: 374604344
VISIT DATE: 02/11/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from 9099)

Review of physicians report (dated 5/10/2024) reveal C1 has a diagnosis with Seizure Disorder and Mental retardation. Individual Service/Behavior intervention plan (dated 1/30/2025) indicates a history of  physical aggression, emotional outbursts, property abuse and elopement.

Interviews with OS1, San Diego Regional Center and Licensee reveal there was not a specific time in place for C1 departure from C1 hospitalization as of February 4, 2025.  Interviews with San Diego Regional Center and the Licensee reveal Licensee agreed to allow C1 back into Licensee residence once C1 was ready for discharge.   In addition, when Licensee went to hospital to get C1 on February 6, 2025, as requested by the hospital, C1 refused to get in the car and was expressing behaviors.  Interview with licensee stated  C1 was transported via air ambulance to C1's residence the next afternoon. The investigation did not disclose any evidence that the licensee purposely excluded C1 from returning to C1's residence. [See LIC 811 Confidential Names List to identify Client #1, Outside source #1 ). Records review and interviews reveal the licensee did not issue an eviction notice for C1 to CCL or to San Diego Regional Center on or before February 6, 2025.  

The Department has investigated the above-mentioned allegation and based on, interviews conducted, and records reviewed there was insufficient evidence to support that the licensee unlawfully evicted a client.  Therefore, this allegation is deemed unsubstantiated.

An exit interview was conducted with Licensee Ericka Jiminez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Amy Rodgers
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2