374604345-11-15-2022-08-AS-SJAB-CLP2HX-20221130162529

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604345
Report Date: 11/15/2022
Date Signed: 11/15/2022 11:56:30 AM

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
02/28/2022 and conducted by Evaluator Esther Miller

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20220228134500

FACILITY NAME:	RANCHO DIGIUS		FACILITY NUMBER:	374604345
ADMINISTRATOR:	MONTES, FROILAN		FACILITY TYPE:	735
ADDRESS:	2445 BROADWAY		TELEPHONE:	(858) 717-0346
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92102
CAPACITY:	49	CENSUS: 44	DATE:	11/15/2022
		UNANNOUNCED	TIME BEGAN:	10:13 AM
MET WITH:	Froilan Montes, Administrator		TIME COMPLETED:	10:31 AM

ALLEGATION(S):

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Staff are not following client's needs and service plan.
Staff did not notify client's authorized representative of client's incident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Esther Miller conducted an unannounced complaint investigation visit to the facility in order to deliver findings on the above-mentioned allegations. LPA was granted entry to the facility by Froilan Montes, Administrator, after identifying herself and explaining the reason for the visit.

On February 28, 2022, it was alleged that the facility did not follow client’s needs and service plan and did not keep client’s authorized representative informed. The Department’s investigation consisted of review of facility records, outside source records, and interviews of facility staff and outside sources.

Client 1 (C1) and Client 2 (C2) are participants of a San Diego County funded case management program that provides mental health services for mentally ill individuals. Administrator stated that progress notes were a requirement for their program. The ASP Client Skill Assessment and Service Plan for C1 and C2

[Continued on LIC9099-C, Page 1 of 2]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Esther Miller
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022

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-20220228134500

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: RANCHO DIGIUS	FACILITY NUMBER: 374604345
	VISIT DATE: 11/15/2022

NARRATIVE

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Continued from LIC9099, Page 2 of 2]

identified goals and a strategy to reach each goal. Facility provided group/classes to clients to help them reach their goals. Facility records did not reveal that documentation of progress notes were to be kept. Outside sources were unavailable for an interview.

On April 9, 2022, the facility self reported an incident involving C1 to Community Care Licensing. In the incident report, facility reported that they contacted law enforcement and C1’s county case manager through a crisis line. Facility records showed that C1 was not conserved and had no other authorized representative to inform of the incident.

Based on the evidence obtained during the complaint investigation, the allegation that the facility did not follow client’s needs and service plan and that licensee did not keep a responsible party informed of a client’s care was found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or may be valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Administrator; a copy of this report and LIC9058 Licensee's Rights were provided.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Esther Miller
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022

LIC9099 (FAS) - (06/04)

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