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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 134604417
Report Date: 05/22/2024
Date Signed: 05/28/2024 12:44:44 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
12/05/2023 and conducted by Evaluator Alyssa Ramirez
COMPLAINT CONTROL NUMBER: 08-AS-20231205162201
FACILITY NAME:SONRISA VILLA INC.FACILITY NUMBER:
134604417
ADMINISTRATOR:OSCAR CHAVEZFACILITY TYPE:
740
ADDRESS:708 E. 5TH ST.TELEPHONE:
(760) 756-3285
CITY:HOLTVILLESTATE: CAZIP CODE:
92250
CAPACITY:175CENSUS: 104DATE:
05/22/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:TIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Resident rooms do not have a working auditory signal system.
Lack of sufficient staffing to meet residents' needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alyssa Ramirez conducted an unannounced complaint visit to deliver findings on the above allegations. LPA met with Manager Gabriela Zamora and discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegations. The investigation consisted of records review, interviews with facility staff, clients and outside agency.

It was reported to CCL that resident rooms do not have a working auditory signal system and there is lack of sufficient staffing to meet resident’s needs.

[Continued on LIC-9099 C]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024
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-20231205162201
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SONRISA VILLA INC.
FACILITY NUMBER: 134604417
VISIT DATE: 05/22/2024
NARRATIVE
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[Continued from LIC 9099]

Regarding the allegation that resident rooms do not have a working auditory signal system, LPA conducted a walk through of the facility and observed working signal systems in rooms that were toured. LPA observed some empty rooms that were being renovated that did not have signal systems although there were no residents residing in those rooms. Interviews with staff revealed that signal systems are in working order and are in all resident bedrooms. Interviews with residents did not avail any concern in regards to signal system.

Regarding the allegation for lack of sufficient staffing to meet resident’s needs, it was reported that there is a staff shortage and residents are not getting proper assistance. Interviews with facility staff revealed no issues with care and supervision. Interviews with residents revealed no concerns for residents not getting their needs met. Interview with Outside Source (OA) revealed concerns for lack of staffing. Insufficient evidence to substantiate allegation due to conflicting statements in regards to staffing.

Based upon the foregoing, the above listed allegations are unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegations are not valid. No deficiencies were cited today.



An exit interview was conducted with Manager Gabriela Zamora. A copy of this report along with licensee rights (LIC 9058) was provided to Manager whose signature below verifies receipt of these rights.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Alyssa Ramirez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024
LIC9099 (FAS) - (06/04)
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