374604477-6-7-2023-08-AS-LTEZ-CSTUBD-20230615152611

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604477
Report Date: 06/07/2023
Date Signed: 06/07/2023 04:20:54 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
06/01/2023 and conducted by Evaluator Natasha Persaud

COMPLAINT CONTROL NUMBER: 08-AS-20230601121058

FACILITY NAME:	SCARLETT'S CARE		FACILITY NUMBER:	374604477
ADMINISTRATOR:	SORENSON, BRADLEY		FACILITY TYPE:	735
ADDRESS:	1024 NEPTUNE DRIVE		TELEPHONE:	(619) 634-1889
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91911
CAPACITY:	4	CENSUS: 2	DATE:	06/07/2023
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Administrator, Yuri Vega		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Facility did not ensure medical treatment for client

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Natasha Persaud conducted an unannounced visit regarding the above mentioned allegation. LPA met with Administrator, Yuri Vega and Licensee, Bradley Sorenson.

During the investigation, the facility was briefly toured, records requested, and interviews conducted with staff, client, and outside sources. It was alleged, the facility did not ensure medical treatment for Client #1 (C1). On 05/23/23, an incident occurred involving two clients. The clients were sitting down for dinner, C1 began imitating Client #2 (C2). C1 then began yelling, cursing and using obscene finger gestures towards C2. C2 became upset with C1 and bit C1 on the head resulting in redness. The caregiver was preparing the client’s meals and was five (5) to six (6) feet away from the clients and intervened immediately. Investigation revealed the facility has one staff and two clients, which is sufficient. Staff provided first aid as they did not believe the injury required medical treatment from a hospital or physician. Continued on an LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

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-20230601121058

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: SCARLETT'S CARE	FACILITY NUMBER: 374604477
	VISIT DATE: 06/07/2023

NARRATIVE

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Staff interviews confirmed medical treatment was not needed outside of first aid. Staff cleaned the red area with antiseptic, applied antibiotic ointment, and scheduled an appointment with C1's physician. C1 was evaluated by their physician on 05/31/23, no treatment was rendered as it was not necessary. There were no new orders or follow up required. Client interviews were unsuccessful.

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 allegation. The allegation is deemed unsubstantiated. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 01/16) were provided to Administrator, Yuri Vega whose signature below confirms receipt of these rights. [See LIC 811 Confidential Names List to identify Client #1 and Client #2]

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Natasha Persaud
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023

LIC9099 (FAS) - (06/04)

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