374604372-1-19-2023-08-AS-LTEZ-CNM2JN-20230131162638

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604372
Report Date: 01/19/2023
Date Signed: 01/19/2023 05:56:20 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
01/05/2023 and conducted by Evaluator Natasha Persaud

COMPLAINT CONTROL NUMBER: 08-AS-20230105095114

FACILITY NAME:	LINO AND AMIE'S BOARD AND CARE INC.		FACILITY NUMBER:	374604372
ADMINISTRATOR:	SUZETTE LAM		FACILITY TYPE:	735
ADDRESS:	11383 SPICA DRIVE		TELEPHONE:	(858) 254-5041
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92126
CAPACITY:	6	CENSUS: 6	DATE:	01/19/2023
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Licensee, Amelia Delacruz		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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-Facility staff physically abused client
-Facility staff yell at the clients

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit to conclude the investigation regarding the above mentioned allegations. LPA met with Licensee, Amelia Delacruz.

During the investigation, a tour of the facility was conducted, records reviewed, and interviews with staff, clients, and outside sources. It was alleged, facility staff physically abused a client. It was reported Staff #1 (S1) slapped Client #1 (C1) across the face leaving a red mark. C1’s Needs and Service Plan dated, 01/01/23 indicated when C1 gets upset they will stop listening to instructions and has a history of hitting others when upset. Interviews conducted revealed there was an argument between S1 and C1 on 01/02/23. S1’s interview revealed bringing the clients back home from dinner and as they were exiting the vehicle, the clients had a verbal argument amongst themselves. The verbal argument continued inside the facility. S1 stated they intervened, then C1 slapped/hit S1 on the arm. S1 followed C1 to their bedroom where the argument continued and ended. Outside source provided that S1 slapped C1 but did not witness the incident. C1 was observed with a reddened area on their cheek. Client interviews revealed witnessing the argument and observing C1 hit S1 on the arm. Clients denied that S1 slapped/hit C1. S1 denied slapping C1 in the face. Witness interviews revealed no one witnessed S1 slap C1 on the face.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

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-20230105095114

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: LINO AND AMIE'S BOARD AND CARE INC.	FACILITY NUMBER: 374604372
	VISIT DATE: 01/19/2023

NARRATIVE

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It was also alleged facility staff yells at clients. Outside source interviews provided S1 came back from out of town, date unknown and was yelling at the clients, as well as yelling during an argument on 01/02/23. Client interviews yielded denial of S1 yelling at the clients on any occasion. S1 denied yelling at the clients. Additional staff interviews revealed never witnessing S1 yell at the clients. Investigation did not reveal specific dates or incidents that involved S1 yelling at the clients.

During the course of the investigation interviews were conducted and records were reviewed. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegations. The allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Licensee, Amelia Delzcruz whose signature below confirms receipt of these rights.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC9099 (FAS) - (06/04)

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