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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005976
Report Date: 07/14/2022
Date Signed: 07/14/2022 10:18:37 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2022 and conducted by Evaluator Jenifer Tirre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220620141344
FACILITY NAME:JOY IN LIFE HOMES IIFACILITY NUMBER:
306005976
ADMINISTRATOR:HANNA, BAHIRAFACILITY TYPE:
740
ADDRESS:19041 WOODWARD LANETELEPHONE:
(951) 741-3267
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92646
CAPACITY:6CENSUS: 4DATE:
07/14/2022
UNANNOUNCEDTIME BEGAN:
09:24 AM
MET WITH:Caregiver, Sandra MattisTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to provide records to family/attorney.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jenifer Tirre made an unannounced visit on this day for the purpose of delivering findings for the above mentioned allegation. LPA was greeted by staff and met with Caregiver Sandra Mattis.

Based on investigation interviews and documents reviewed, Licensee received letter for records on 6/16/22 with a two day due date. Licensee sent copies of records on 6/24/22. Investigation revealed that Licensee provided proof of sending records to family attorney and Family Attorney Represenative confirmed receiving records after due date. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are deemed UNSUBSTANTIATED.

An exit interview interview was conducted with Caregiver and copy of this report was left at facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
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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