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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604477
Report Date: 12/03/2024
Date Signed: 01/03/2025 03:35:50 PM

Document Has Been Signed on 01/03/2025 03:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SCARLETT'S CAREFACILITY NUMBER:
374604477
ADMINISTRATOR/
DIRECTOR:		SORENSON, BRADLEYFACILITY TYPE:
735
ADDRESS:1024 NEPTUNE DRIVETELEPHONE:
(619) 500-5339
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 4CENSUS: 3DATE:
12/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:House Manager Carmila "Starr" Austin and Administrator Monica McDadeTIME VISIT/
INSPECTION COMPLETED:
06:00 PM
NARRATIVE
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[This report was originally authored on 12/03/2024. An amended version of the report was personally served to Licensee on 01/03/2025].

Licensing Program Analyst (LPA) Dang Nguyen conducted an unannounced Case Management - Incident visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with House Manager Carmila "Starr" Austin. LPA also met with Administrator Monica McDade, who arrived later during the visit.

Today's visit was in response to multiple Special Incident Repots (SIRs) and SOC341 Reports of Suspected Dependent Adult Abuse, all involving the same incident, which Licensee self-submitted to the CCLD San Diego Regional Office (all were received on 11/07/2024).

According to these reports, and corroborated by staff interviews during today’s site visit: On 10/25/2024, Licensee attempted to access for review the Personal and Incidental (P&I) monies belonging to the three clients in care, Client #1 (C1), Client #2 (C2), and Client #3 (C3), which Licensee was responsible for safeguarding. Licensee discovered that that the P&I money and records belonging to C1 and C2 were missing, and that the P&I records belonging to C1, C2, and C3 were missing. [See LIC 811 Confidential Names List for a description of person identifiers used in this report]. Licensee contacted Staff #1 (S1), who had keys to the locked cabinet where the P&I monies and records were kept. S1 confirmed that they took the monies and records. Licensee asked S1 to return these items, but S1 did not comply.


[CONTINUED ON LIC 809-C]

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 12/03/2024
NARRATIVE
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[CONTINUED FROM LIC 809]

Records and staff interviews showed: S1 stole around $600 of C1’s P&I money and $354 of C2’s P&I money. Additionally, S1 stole around $500 which C2’s father gave to S1, under the impression that S1 was adding it to C2’s funds. C3 did not maintain any monies under Licensee’s care, and therefore had no dollar loss. Upon the discovery of theft, Licensee timely reported the incident to appropriate agencies, to include law enforcement. Licensee subsequently reimbursed C1 for $600, and reimbursed C2 for $354. [S1’s last worked day at the facility was 10/29/2024, and they had not since returned. Licensee since terminated S1’s employment at the facility.]

During LPA’s 12/03/2024 site visit, he counted the clients’ P&I funds, verifying that the cash on hand matched the latest running balance for each client in care, based on the latest reconstructed P&I records as of that date (since S1 also took the original P&I records with them). Interviews of the parent/responsible person for C1 and C2 confirmed that Licensee subsequently reimbursed each client in full for the stolen dollar amounts.

Staff interviews further showed: On 10/25/2024, a facility manager and the administrator-on-duty that day, Staff #2 (S2), made a false or misleading statement to CCLD, by telling LPA that none of the three (3) clients entrusted/maintained their P&I monies with the Licensee on that date, when in actuality, C1 and C2 did maintain their monies with Licensee. Interview of S2 and another manager confirmed that S2 first recognized these monies and records were missing during LPA’s 10/25/2024 annual inspection visit, but they knowing lied to LPA. [On 12/14/2024, S2 resigned/terminated their own employment at the facility.]

A preponderance of evidence exists to show that Licensee’s staff (S1) stole money belonging to C1 and C2, and that Licensee’s manager (S2) made a false or misleading statement regarding the facility. Two (2) deficiencies were cited per California Code of Regulations, Title 22 (refer to the attached LIC 809-D). Plans of Correction were jointly developed with the Licensee.

An exit interview was conducted with McDade, to whom a copy of this report, the LIC 809-D page, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/03/2025 03:36 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 01/03/2025 02:40 PM


Created By: Dang Nguyen On 12/03/2024 at 05:17 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/03/2025
Section Cited
CCR
85072(b)(7)

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85072 Personal Rights: “(b) The licensee shall insure that each client is accorded the following personal rights. (7) To possess and control his/her own cash resources.” This requirement was not met, as evidenced by:
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As of the date of deficiency issuance, S1 no longer works at the facility. Records and interviews of staff and outside sources confirmed that Licensee subsequently reimbursed C1 and C2 each, for their total dollar loss. Licensee also agreed to conduct a training in-service for all remaining staff on Client’s Personal Rights (using forms DSP 304 and LIC613 which LPA provided), and to email a copy of the training sign-in sheet to LPA, by the POC due date.
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Based on records and interviews, due to the actions of a staff, Licensee did not ensure that 2 of 3 clients (C1 and C2) remained in continuous possession and control of their own cash resources. This posed a potential personal rights risk to persons in care.
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Type B
12/03/2024
Section Cited
CCR80012(a)

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80012 False Claims: “(a) No licensee, officer, or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.” This requirement was not met, as evidenced by:
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On 12/03/2024, S2 provided to LPA the true/correct information about what occurred on 10/25/2024. This action resolved the deficiency. On 12/14/2024, S2 resigned/terminated their employment at the facility. The Plan of Correction is Satisfied.
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Based on LPA observation and interviews, 1 of 13 employees (S2) of Licensee made a false or misleading statement to CCLD regarding the facility. This posed a potential personal rights risk to 2 of 3 clients (C1 and C2) 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.
SUPERVISOR'S NAME:Lizzette Tellez
LICENSING EVALUATOR NAME:Dang Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 12/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2024


LIC809 (FAS) - (06/04)
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