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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604368
Report Date: 11/09/2022
Date Signed: 11/09/2022 11:59:03 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/31/2022 and conducted by Evaluator Chinwe Nwogene
COMPLAINT CONTROL NUMBER: 18-AS-20221031162036
FACILITY NAME:MERAKEY - AMPAROFACILITY NUMBER:
374604368
ADMINISTRATOR:LYLES, BRITTANNYFACILITY TYPE:
737
ADDRESS:479 AMPARO DRIVETELEPHONE:
(442) 277-4554
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:4CENSUS: 4DATE:
11/09/2022
UNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Michelle Mitchell, AdministratorTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Staff did not ensure that hazardous items were inaccessible to clients.
INVESTIGATION FINDINGS:
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On November 9, 2022, Licensing Program Analyst (LPA), Chinwe Nwogene conducted an unannounced visit for the purpose of investigating the above allegation. At the time of visit, LPA met with Administrator, Michelle Mitchell and explained the purpose of the visit. During this investigation LPA interviewed reporting party (RP), staff, and conducted an inspection of the facility.
Regarding the allegation “Staff did not ensure that hazardous items were inaccessible to clients”. Interview with RP revealed during RP’s visit to the facility, a cleaning solution was found under resident #1 (R1) bed. LPA interviewed Administrator and staff who admitted the cleaning solution was left under residents’ bed by mistake. Administrator stated the cleaning solution was immediately locked up and made inaccessible to residents. LPA conducted an inspection of the facility and observed the cleaning solutions to be adequately secured.
Based on LPA’s interview the preponderance of evidence standard has been met. Therefore, the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division & Chapter number 6) are being cited on the attached LIC 9099D). An exit interview was conducted, and a copy of this report was reviewed with and provided to Michelle Mitchell.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/31/2022 and conducted by Evaluator Chinwe Nwogene
COMPLAINT CONTROL NUMBER: 18-AS-20221031162036

FACILITY NAME:MERAKEY - AMPAROFACILITY NUMBER:
374604368
ADMINISTRATOR:LYLES, BRITTANNYFACILITY TYPE:
737
ADDRESS:479 AMPARO DRIVETELEPHONE:
(442) 277-4554
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:4CENSUS: 4DATE:
11/09/2022
UNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Michelle Mitchell, AdministratorTIME COMPLETED:
12:10 PM
ALLEGATION(S):
1
2
3
4
5
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8
9
Staff did not keep the facility clean.
INVESTIGATION FINDINGS:
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On November 9, 2022, Licensing Program Analyst (LPA), Chinwe Nwogene conducted an unannounced visit for the purpose of investigating the above allegation. At the time of visit LPA met with Administrator, Michelle Mitchell and explained the purpose of the visit. During this investigation, LPA interviewed reporting party (RP), staff, and conducted an inspection of the facility.
Regarding the allegation “Staff did not keep the facility clean”. Interview with RP revealed during RP’s visit to the facility, RP observed resident #1 (R1) bedroom to be dusty. LPA interviewed Administrator and staff who stated R1 bedroom is cleaned and dusted everyday by staff assigned to R1. LPA conducted an inspection of the facility including R1 bedroom and observed facility to be clean.
Based on LPA’s interview and observation there is not enough evidence that “Staff did not keep the facility clean”. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated at this time. An exit interview was conducted, and a copy of this report was reviewed with and provided to Michelle Mitchell.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20221031162036
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: MERAKEY - AMPARO
FACILITY NUMBER: 374604368
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/10/2022
Section Cited
CCR
80087(g)
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Buildings and Grounds;

(g) Disinfectants, cleaning solutions, poisons, firearms and other items that could pose a danger if readily available to clients shall be stored where inaccessible to clients.
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Administrator, Michelle Mitchell stated the cleaning solution was immediately locked up and made inaccessible to residents. LPA observed the cleaning solutions to be adequately secured.
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This requirement is not met based as evidence by interview. The licensee did not comply by leaving a cleaning solution under resident’s bed which poses a potential health, safety or personal rights risk to persons in care.
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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: Deborah Mullen
LICENSING EVALUATOR NAME: Chinwe Nwogene
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3