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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604419
Report Date: 07/17/2024
Date Signed: 07/17/2024 05:05:34 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
07/10/2024 and conducted by Evaluator Liliana Silveira
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20240710150735
FACILITY NAME:RUSSELL HOMES, INC HARBISONFACILITY NUMBER:
374604419
ADMINISTRATOR:RUSSELL, STACEYFACILITY TYPE:
735
ADDRESS:810 ST. GEORGE DR.TELEPHONE:
(619) 612-2245
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:4CENSUS: 3DATE:
07/17/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Program Director Shontel GrivnoTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Unlawful eviction.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to deliver findings for a complaint investigation for the above-mentioned allegation. LPA identified herself, disclosed the purpose of the visit and was allowed entry by Caregiver Michael Russell. Program Director Shontel Grivno arrived shortly after.

The Department’s investigation consisted of a records review, interviews and LPA observations. On 07/10/24 it was alleged that Client #1 (C1) received an unlawful eviction. A department interview with an outside source revealed that C1 had been admitted to the hospital on 07/01/24 and was ready to be released on 07/03/24, but the facility refused to accept the client back due to the client displaying high level behavioral episodes and due to the client needing a higher level of care. (continued on next page, LIC 9099-C)

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
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-20240710150735
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: RUSSELL HOMES, INC HARBISON
FACILITY NUMBER: 374604419
VISIT DATE: 07/17/2024
NARRATIVE
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(CONTINUED FROM LIC 9099) A records review and department interviews revealed that a thirty day (30) eviction notice was issued to C1 and C1’s responsible parties on 04/05/24. This was the second eviction notice issued to the client, the first having been issued on 02/19/24.

Department interviews conducted with outside sources and the facility Administrator also revealed that C1 was issued temporary placement in a new facility on 07/13/24. Interviews with outside sources and the Administrator also revealed that San Diego Regional Center (SDRC) is looking to place C1 in a facility that provides a higher level of care.

Due to a lack of corroborating evidence, the allegation that a resident was unlawfully evicted is unsubstantiated. This finding means that although the allegation may have happened or could be valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

LPA Silveira conducted an exit interview with Shontel. At the time of the exit interview Shontel was provided with a copy of the Complaint Investigation Report (LIC9099) and Licensee Rights (LIC9058 01-2016). The signature on this report acknowledges receipt of the rights.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Liliana Silveira
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2