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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604688
Report Date: 08/05/2025
Date Signed: 08/05/2025 03:40:11 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
02/13/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250213154129
FACILITY NAME:VILLA KALI MAFACILITY NUMBER:
374604688
ADMINISTRATOR:AMUNDSON, ASHLEYFACILITY TYPE:
772
ADDRESS:17676 VISTA RANCHO COURTTELEPHONE:
(760) 683-5152
CITY:RANCHO SANTA FESTATE: CAZIP CODE:
92067
CAPACITY:6CENSUS: 6DATE:
08/05/2025
UNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Lizzie Powell,Operations MGRTIME COMPLETED:
03:35 PM
ALLEGATION(S):
1
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5
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7
8
9
Staff spoke inappropriately to client
INVESTIGATION FINDINGS:
1
2
3
4
5
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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 Lizzie Powell,Operations MGR

LPA previously conducted interviews with residents, staff, and outside sources, made observations, and obtained and reviewed pertinent records. LPA conducted the initial visit on February 19, 2025 and conducted a tour of the facility. It was alleged that staff spoke inappropriately to client. Interviews revealed that during their meetings, the staff speaks to them with respect and privacy. Interviews with clients did not reveal any staff spoke to them inappropriately. Interviews with staff revealed there was a client that was at the short term facility back in May of 2024 that was offended by one of the other clients and felt as though the staff should have said something to the client. Interviews revealed the client in question made a scene and called staff and clients names. Interviews revealed the clients come to the treatment facility for a short time and they are not at the facility for months at a time. Interviews did not provide any evidence that revealed staff speak to the clients inappropriately.

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 Lizzie Powell,Operations MGRvia 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: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025
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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