405850524-3-6-2025-29-AS-KBUY-DF7P32-20250328105650

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850524
Report Date: 03/06/2025
Date Signed: 03/06/2025 03:30:03 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
01/13/2025 and conducted by Evaluator Mark Jeffries

COMPLAINT CONTROL NUMBER: 29-AS-20250113152139

FACILITY NAME:	ROBLES RANCH MENTAL HEALTH		FACILITY NUMBER:	405850524
ADMINISTRATOR:	ASHLEY, CHEREE		FACILITY TYPE:	772
ADDRESS:	175 CRIPPLE CREEK ROAD		TELEPHONE:	(831) 245-7736
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	6	CENSUS: 5	DATE:	03/06/2025
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Program Director, Will Harris		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff do not have adequate training.
Residents are not being provided with appropriate food service.
Staff not meeting qualifications as outlined in facility Plan of Operations.

INVESTIGATION FINDINGS:

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At 12:30pm on 03/06/2025, Licensing Program Analyst (LPA) Jeffries and Haner-Tomasko arrived unannounced to the facility to issue final findings to the allegations to this complaint. LPA's met with facility Program Director, Will Harris, announced who they are and the reason for the visit.

As to the allegations of, “Staff do not have adequate training.” It was alleged that Staff 4 (S4) is dispensing medications without the proper training. It was discovered through documentation and interviews that on 01/17/2025, LPA Jeffries conducted interviews with S1, S2 and S3. S1-3 all stated that staff at the facility get full training or are fully qualified before that start working in the facility. On 01/17/2025 LPA Jeffries conducted an interview with S4, who stated that they have had medication administration training prior to passing medications at this facility. On 01/29/2025, LPA Jeffries reviewed training documentation “Robles Ranch Staff Training Guide: Medication Management” dated 01/06/2025 for S4 stating “fully trained”(shows 36 hours of training specific to medications).
CONTINUED on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

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 3

Control Number 29-AS-20250113152139

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: ROBLES RANCH MENTAL HEALTH	FACILITY NUMBER: 405850524
	VISIT DATE: 03/06/2025

NARRATIVE

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On 01/17/2025, LPA Jeffries conducted interviews with Residents 1, 2, and 3 (R1, R2, and R3) who all stated that they have not had any issues with medication while at this facility. As this time there is not enough evidence to support the allegation of, “Staff do not have adequate training.” and is unsubstantiated at this time.

As to the allegation of, “Residents are not being provide with appropriate food service." It was alleged that R2 had modified diet due to diabetes, but nothing was changed in their diet was changed at all." It was discovered through in interview on 01/17/2025 with R2 that the facility has excellent menu choices and a variety of foods that meets R2’s dietary restrictions. R2 stated that the first evening they arrived at the facility they had made a specific food request and the food request was fulfilled that next morning. R2 stated they had “Zero issues” with food at the facility and they are please with food choices. On 01/17/2025, LPA Jeffries conducted an interview with S2 who stated that they facility allows for client’s choice in food request and when new clients come in they are screened for dietary requirements and preferences. On 01/17/2025, LPA Jeffries observed a weekly menu posted in the kitchen of the facility. At this time there is not enough evidence to support the allegation of, “Residents are not being provided with appropriate food services.”

CONTINUED on LIC9099-C

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250113152139

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: ROBLES RANCH MENTAL HEALTH	FACILITY NUMBER: 405850524
	VISIT DATE: 03/06/2025

NARRATIVE

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As to the allegation of, “Staff not meeting qualifications as outlined in facility Plan of Operations.” It was alleged that, S6 was not qualified to work as therapist under facilities plan of operations. It was discovered though documentation and interviews that on 01/17/2025, LPA Jeffries conducted an interview with Witness 1 (W1) who stated that therapy S6 is conducting is miss characterized as “life coaching” however, W1 believes that the “life coaching” is therapy. On 01/21/2025, LPA Jeffries reviewed the Community Care Licensing the approved Plan of Operations for the facility which states on page 6, “The Program will provide a therapeutic environment in which residents are supported during their efforts to acquire and apply interpersonal and independent living skills. The program will assist the resident in developing a personal community support system to substitute for the programs’ supportive environment and to minimize the risk of hospitalization and enhance the capability for independent living upon discharge from the program.” Including: 6. Instruction in all areas of basic living skills such as meal planning and preparation, household cleaning and maintenance, basic personal hygiene, budgeting, use of public T, maintenance of medication regimen. 7. Individualized vocational/educational assessment, guidance, and placement assistance. LPA also noted that On 03/05/2025 LPA confirmed with facility Program Director that S6 job title was Case Manager; on page 129 of facilities Plan of Operation stated Job Title for Case Manager and qualifications as follows:
● Individual holds current CPR / First Aid Certification, BLS or ACLS preferred.
● Requires a Master’s Degree in Social Work, Psychology, Counseling and/or a Master’s Degree with five (5) Years relevant social work experience.
● Requires six (6) months of clinical experience in an HMO, medical group, affiliated model, hospital or medical/office/clinic setting.
On 03/05/2025, LPA Jeffries reviewed S6, CPR/1st Aide training dated December 16, 2024,(good for 2 years); Accredited college transcript indicating a Master in Arts on 07/14/2007; and S6 resume illustrating over 17 years of relative social work experience all within clinical settings. On 01/17/2025, LPA reviewed all staff working that the facility to be fingerprint cleared. At this time there is no evidence to support the allegation of, “Staff not meeting qualifications as outlined in facility Plan of Operations.” and is unsubstantiated at this time.

Exit interview, report read and report provided.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025

LIC9099 (FAS) - (06/04)

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