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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604419
Report Date: 07/08/2025
Date Signed: 07/08/2025 05:14:02 PM

Substantiated


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
07/02/2025 and conducted by Evaluator Iby Strong
COMPLAINT CONTROL NUMBER: 08-AS-20250702114522
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:
07/08/2025
UNANNOUNCEDTIME BEGAN:
10:23 AM
MET WITH:House Manager Michael RussellTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff restrained client in a prohibited physical hold.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation the above complaint allegation. LPA identified herself and discussed the purpose of the visit with House Manager Michael Russell. Administrator Krista Duvall arrived shortly after.

On July 2, 2025, Community Care Licensing (CCL) received a complaint alleging Staff 1 (S1) placed Client 1(C1) in a prohibited physical hold after an altercation. According to the allegation, on June 28, 2025, C1 had an aggressive behavior towards S1 hitting and whipping S1 with a cord, S1 then proceeded to verbalized to C1 to stop such behavior but C1 continued, S1 then placed C1 in a chokehold.

C1’s Individual Program Plan revealed that C1 has a history of physically aggressive behaviors against other clients and staff.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025
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 5
Control Number 08-AS-20250702114522
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: 07/08/2025
NARRATIVE
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Additional records collected revealed that C1 was recently removed from their Day Program for continuous violent behaviors towards others. Interview with S1 established that C1 was continuously hitting and whipping S1 with a cell phone cord causing S1 multiple injuries. S1 stated that they were left with no choice but to restrain C1. S1 stated that during the incident both S1 and C1 fell to the ground and S1 was able to put their arms around C1, holding down both arms and hands and push C1’s mouth closed to prevent C1 from biting. According to staff, S1 held C1 for an period of time. S1 records reviewed reveal S1 did not have emergency intervention training.

During an interview with C1, C1 denied the incident. Interview with an outside source established that C1 has had an increase in aggressive behaviors over the last 12 months.

Based on staff and outside source interviews conducted and records reviewed a preponderance of evidence exists to support the allegation. A deficiency is cited per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D). An exit interview was conducted with Administrator Krista Duvall, and a Plan of Correction was jointly developed. A copy of this report, LIC811, LIC 9099-C, LIC 9099-D, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided and , signature on this form confirms receipt of documents
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20250702114522
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2025
Section Cited
CCR
85102(a)(2)
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(a) The following emergency interventions shall not be used on a client:
(2) Manual restraint as an extended procedure;

This requirement was not met as in evidence:
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Adminisitrator states they will provide deescalation training for staff.
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Based on interviews the licensee did not ensure staff were trained for manual restraints and used a restraint for an extended procedure in 1 of 3 persons in care which posed a potential 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: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
07/02/2025 and conducted by Evaluator Iby Strong
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20250702114522

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: DATE:
07/08/2025
UNANNOUNCEDTIME BEGAN:
10:23 AM
MET WITH:House Manager Michael RussellTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff yelled at client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation the above complaint allegation. LPA identified herself and discussed the purpose of the visit with House Manager Michael Russell. Administrator Krista Duvall arrived shortly after.

On July 2, 2025, Community Care Licensing (CCL) received a complaint alleging Staff 1 (S1) yelled at C1 during an incident. According to the allegation, on June 28, 2025, C1 had an aggressive behavior towards S1, during the incident it was alleged that S1 and C1 were yelling at each other and saying things they did not mean.C1’s Individual Program Plan revealed that C1 has a history of physically aggressive behaviors against other clients and staff. Additional records collected revealed that C1 was recently removed from their Day Program for continuous violent behaviors towards others. Interview with S1 established that S1 did not yell or curse at C1 during the incident. S1 revealed that they asked C1 multiple times to stop the attack but C1 continued. S1 also established that C1 was cursing during the event.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20250702114522
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: 07/08/2025
NARRATIVE
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During an interview with C1, C1 denied the incident. Interview with an outside source established that C1 has had an increase in aggressive behaviors over the last 12 months.

Based on interviews, and record reviews there is not a preponderance of evidence to prove alleged violations occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with Administrator Krista Duvall, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5