374604690-12-12-2023-08-AS-DPOL-CYQP47-20231221095840

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604690
Report Date: 12/12/2023
Date Signed: 12/12/2023 10:28:57 AM

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
10/19/2023 and conducted by Evaluator Renita Hall

COMPLAINT CONTROL NUMBER: 08-AS-20231019143629

FACILITY NAME:	CARROLL'S RESIDENTIAL CARE		FACILITY NUMBER:	374604690
ADMINISTRATOR:	MEYERS, BRYAN		FACILITY TYPE:	740
ADDRESS:	655 S MOLLISON AVE		TELEPHONE:	(619) 444-3181
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY:	144	CENSUS: 125	DATE:	12/12/2023
		UNANNOUNCED	TIME BEGAN:	09:58 AM
MET WITH:	Sarita Mendoza, Assistant Manager		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility staff did not treat resident with diginity

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit to deliver findings regarding the above-mentioned allegation LPA was allowed entry by Sarita Mendoza, Assistant Manager. LPA identified herself and disclosed the purpose of the visit and elements of the findings to the Assistant Manager.

On October 19, 2023, an allegation was made against Carroll's Residential Care regarding facility staff did not treat a resident with dignity by threatening to evict the resident for an unkempt room. LPA Hall interviewed the residents and staff members who may have witnessed or had relevant information regarding the incident. LPA reviewed relevant documentation, including resident care plans, and other relevant records. LPA observed the facility's operations, staff interactions with residents, and the overall environment.

Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) -76-2317
LICENSING EVALUATOR NAME: Renita Hall	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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-20231019143629

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: CARROLL'S RESIDENTIAL CARE	FACILITY NUMBER: 374604690
	VISIT DATE: 12/12/2023

NARRATIVE

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Allegation: Staff did not treat a resident with dignity. After conducting interviews with residents and staff members, no evidence was found to support the claim. The resident's statements were consistent with the witness. However, the complainant also witnessed the resident's room in previous times as: "the dresser would be messy with plates, empty cups and cans on the dresser." Which would violate the house rules of the facility: "The room must be clutter-free at all times. If you fail to keep your room clutter-free and refuse to work with management you will be given notice to move out."

Based on the investigation findings, the allegation made against Carroll's Residential Care regarding Staff did not treat a resident with dignity is unsubstantiated. There is no evidence to support the claims that the resident was threatened with being evicted only that the resident was reminded of house rules of keeping the room clean is a part of the admission agreement and eviction was possible with repeated violations. A finding that is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with the Assistant Manager. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Assistant Manager and her signature on this report confirms receipt of the Licensee Rights.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) -76-2317
LICENSING EVALUATOR NAME: Renita Hall	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

LIC9099 (FAS) - (06/04)

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