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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604801
Report Date: 08/26/2025
Date Signed: 08/26/2025 10:26:56 AM

Substantiated


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
08/20/2025 and conducted by Evaluator Tiffany Holmes
COMPLAINT CONTROL NUMBER: 08-AS-20250820131017
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:
08/26/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Bashar Putrus, CaregiverTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff did not keep the facility free of bed bugs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)Tiffany Holmes conducted an unannounced complaint visit to the facility to open a complaint on the above-mentioned allegation. 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, and conducted interviewes. It was alleged that staff did not keep the facility free of bed bugs. Interviews revealed that staff sprayed the room and changed the clients bedding on yesterday, 08/25/2025. Upon LPA Holmes observation of Client 1 (C1s) bed during today's visit, it looks as though the bedding was not washed. The bedding had several spots of dry blood. Interviews revealed that (C!) allowed staff and LPA today to observe bedding while they were laying down and that was all. Interviews with C1 revealed that the other two staff yesterday found bugs and that is why htey sprayed their bed and their roommates bed as well. Interviews with C2 revealed they did not find any bugs on their bed.

Based on the evidence obtained from interviews, the complaint allegation is substantiated. A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met.

A deficiency is cited per Title 22 California Code of Regulation on the 9099 D page. 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.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20250820131017
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: CAVELARIS COMMUNITY CARE
FACILITY NUMBER: 374604801
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/05/2025
Section Cited
CCR
80072(a)(2)
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Personal Rights. To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment to meet his/her needs. This requirement is not met as evidenced by:
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Licensee will have the pest control company come to the facility to eradicate the bed bugs. Licensee will wash all clients clothing in hot water and make sure clients beddings are clean. POC due to CCL by 09/05/2025
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Based on observations and interviews, the licensee did not accord healthful accommodations to 1 out 22 clients [C1], which poses a health, safety, and personal rights risk to clients 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.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Tiffany Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2