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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604801
Report Date: 08/19/2025
Date Signed: 08/19/2025 11:52:40 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
03/17/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250317162157
FACILITY NAME:CAVELARIS COMMUNITY CAREFACILITY NUMBER:
374604801
ADMINISTRATOR:MERZIOTIS, MARGAUXFACILITY TYPE:
735
ADDRESS:9975 SAN JUAN STTELEPHONE:
(619) 370-6733
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:22CENSUS: 22DATE:
08/19/2025
UNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Bashar Putrus, CaregiverTIME COMPLETED:
11:55 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of supervision resulted in client on client altercation
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to open a complaint on the above-mentioned allegations. LPA gained access to the facility, identified herself, and met with Bashar Putrus, caregiver to discuss the purpose of the visit.

LPA conducted conducted a tour of the facility, conducted interviewes and reviewed records. It was alleged that lack of supervision resulted in client on client altercation. Interviews revealed there are usually two staff at the facility on each shift. Interviews revealed that there was an incident between Client 1 (C1) and Client 2 (C2). Interviews revealed C1 was having bad hallucinations and was paranoid and kept saying that C2 was taking their items. Interviews revealed that C2 received medical attention once 911 arrived. Interviews revealed C2 was transported to the hospital for medical evaluation. Interviews revealed C1 was taken to the Hospital for 5150 psychiatric evaluation. Interviews revealed C1 stayed at the hospital for a couple of days and C2 returned same day. Interviews revealed the two staff were at the facility when the incident took place. Interviews with staff revealed the staff don't let the clients argue or have fights. The staff will mediate between the clients. Interviews revealed that the clients do argue and have altercations and the staff will redirect them. Interviews revealed the staff supervise the clients, cook their meals and assist them with anything else they need help with around the facility. Interviews stated that The don't let the clients have altercations in front of them. If there is an incident that occurs while staff are moving around the facility they will either hear it or another client will come and tell them and they try to resolve it with the clients.

Based on the evidence obtained from interviews, 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 Bashar Putrus, Caregiver and a copy of this report along with Licensee/Appeal Rights (LIC 9058 03/22) was provided at the conclusion of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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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