405800333-5-29-2026-29-AS-KBUY-DVJSCR-20260630134600

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405800333
Report Date: 05/29/2026
Date Signed: 05/29/2026 01:51:34 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/22/2026 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20260522113913

FACILITY NAME:	C.A.L.L.-PALOMAR HOUSE		FACILITY NUMBER:	405800333
ADMINISTRATOR:	ADAM J CALLOWAY		FACILITY TYPE:	735
ADDRESS:	8902 PALOMAR		TELEPHONE:	(805) 462-2421
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY:	6	CENSUS: 5	DATE:	05/29/2026
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Adam J Calloway, Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff engage in inappropriate activities while in the presence of client

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) De Leon conducted a 10-day complaint visit to the facility above. LPA met with Administrator Adam Calloway and explained the purpose of the visit.

LPA requested the following records: Staff Roster, Resident Roster, Staff Schedule for this week of May 2026, Resident 1's (R1's) IPP, R1's Behavioral plan and staff disciplinary records for the staff working at the facility.

LPA spoke with C.A.L.L. ED Justin Penrod and ED will watch the video surveillance cameras at the facility for May 2026 to see if R1 is with 2 staff in the office daily for extended periods of time and will report back to LPA. ED stated a staff was recently terminated from the home and will send over a copy of the staffs disciplinary records. LPA interviewed Staff at 10:05am, 10:30am, 10:45am, 11:35am, 11:50am,11:57am and 12:53pm. The residents at the home are non-verbal and LPA was unable to interview. Cont 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026

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 29-AS-20260522113913

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: C.A.L.L.-PALOMAR HOUSE	FACILITY NUMBER: 405800333
	VISIT DATE: 05/29/2026

NARRATIVE

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On the allegation: Staff engage in inappropriate activities while in the presence of client. LPA interviewed Staff which revealed 7 out of 7 staff stated staff are not engaging in any inappropriate activities with any of the residents in care. Staff stated Resident 1(R1) goes to day program 5 days a week Monday-Friday from 9am-2:30pm daily. The AM Staff working Monday-Friday AM shift will get clients up, showered, dressed, fed and off to day programs, the AM staff leave shift at 3:00pm. 4 out of 7 staff interviewed stated the staff at the house get along, work well together, and have never seen Administrator, and or Staff 2 (S2) locked in the office for long periods of time with R1. 6 out of 7 staff said the Administrator is professional, does a good job, takes clients to appointments and works in the main office downtown sometimes as part of the Administrator duties. 2 of 7 staff stated they did see R1 with Administrator, S2 and the Supervisor over all the CALL facilities in the office with the door closed. 1 of 7 staff said they went into the office, and nothing was going on that was inappropriate with the R1. 6 out of 7 staff stated they like the administrator and do not feel the Administrator shows favoritism to certain staff at the facility. 5 out of 7 staff have heard of staff relationships going on but have not felt any favoritism in the way the staff are being treated at the facility.

Administrator stated that R1 has gone into the office with Administrator and other staff on about 2 occasions over the last month and nothing inappropriate has ever gone on. Administrator stated R1 is a 1:1 ratio with staff and the regular staff that covered the shift for R1’s 1:1 was terminated from employment around the beginning of May 2026, several staff have been covering the 1:1 shift with R1, since then a new staff was hired to take on R1's 1:1 care. Based on interviews this allegation is Unsubstantiated at this time.

Exit interview conducted and copy of report printed for Administrator.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026

LIC9099 (FAS) - (06/04)

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