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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604579
Report Date: 08/04/2025
Date Signed: 08/04/2025 02:18:36 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
11/05/2024 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20241105142914
FACILITY NAME:HEALING ADULT GROUP CARE INC.FACILITY NUMBER:
374604579
ADMINISTRATOR:SAIF, SALLYFACILITY TYPE:
735
ADDRESS:3919 EL CANTO DR.TELEPHONE:
(248) 307-6966
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:6CENSUS: 6DATE:
08/04/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Sally Saif, AdministratorTIME COMPLETED:
02:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Client sustained bruises from unknown source
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA)Tiffany Holmes contacted the facility to deliver findings for a complaint investigation via tele-virtual. LPA identified herself to, and explained the purpose of the visit and the basic elements of the complaint with Sally Saif, Administrator.

LPA previously conducted interviews with residents, staff, and outside sources, made observations, and obtained and reviewed pertinent records. LPA conducted the initial visit on 11/07/2024 and conducted a tour of the facility. It was alleged that Client 1 (C1) sustained bruises from unknown source. Interviews revealed that C1 went to program on 11/01/2024 after staying home due to not feeling well. C1 came home the same day with a bruise from program. According to interviews, it was revealed that C1 fell while at the program and the program did not report the client falling. Interviews also revealed staff at program knew about C1 falling and the program did not report the fall to the facility. Interviews revealed C1 did not fall or have any incidents while at the facility. Interviews revealed staff at the day program deny C1 falling or getting injured while in their care. C1 is diagnosed with Down syndrome, Intellectual disability and schizophrenia and is unable to communicate; C1 requires assistance with all grooming, medication, bathing, toileting, and management of personal resources which staff assists C1 with.

The Department has investigated the above-mentioned allegation and based on interviews, LPA observations, and records review, it was determined that the complaint allegation is Unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Sally Saif, Administrator via face time and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided via email. An electronic email read receipt confirms the documents were received.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2025
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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