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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 370804788
Report Date: 09/26/2025
Date Signed: 09/26/2025 08:45:55 PM

Unsubstantiated


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
04/03/2024 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 08-AS-20240403084231
FACILITY NAME:CASA EL CAJONFACILITY NUMBER:
370804788
ADMINISTRATOR:REBECCA RAYOFACILITY TYPE:
740
ADDRESS:306 SHADY LANETELEPHONE:
(619) 440-1335
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:99CENSUS: 83DATE:
09/26/2025
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Administrator, Rebecca RayoTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff neglect/lack of supervision led to resident falling and sustaining a fractured right shoulder.
Facility did not perform a reappraisal to confirm resident needed a higher level of care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sarah Hurt conducted a telephone call on 09/26/2025 to deliver Complaint findings. LPA spoke with facility Admininstrator Rebecca Rayo and expalined the purpose of the phone call.


Regarding the allegation staff neglect/ lack of supervision led to resident falling and sustaining a fractured right shoulder. On 03/30/2024, Resident 1 sustained an unwitnessed fall while walking and was transported to Grossmont Hospital. Resident 1 reported they lost their balance and fell on their right shoulder, denying head trauma or loss of consciousness. Resident 1 was discharged the same day with a non-surgical fracture and pain management instructions. On 03/31/2024 facility noted Resident 1 was lethargic, unable to ambulate, or perform basic tasks. Administrator transported Resident 1 back to the hospital, where the social worker determined he required a higher level of care.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
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-20240403084231
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: CASA EL CAJON
FACILITY NUMBER: 370804788
VISIT DATE: 09/26/2025
NARRATIVE
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Resident 1 was later transferred to a skilled nursing facility for short-term rehabilitation before returning to the facility with Home Health services. Although Resident 1 did sustain an injury, evidence shows facility staff responded appropriately by seeking medical treatment and monitoring his condition. There is insufficient evidence to prove neglect or lack of supervision directly caused the fall or injury. Based on interviews conducted and records reviewed, the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged did or did not occur.


Regarding the allegation facility did not perform a reappraisal to confirm resident needed a higher level of care. On 03/31/2024, Facility Administrators observed Resident 1’s change in condition and immediately arranged for his return to the hospital, informing staff he could not return to the facility unless independent. Resident 1 was placed at skilled nursing for physical therapy and later cleared by a physician to return to the facility with Home Health support. The facility Administrator identified Resident 1’s increased care needs, initiated transfer to a higher level of care, and coordinated follow-up. Upon re-evaluation, Resident 1 was determined to again meet the criteria for independent living with Home Health assistance. Based on interviews conducted and records reviewed, the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged did or did not occur.

No deficiencies cited Per title 22 regulations. Exit interview was conducted with facility Administrator Rebecca Rayo.

A copy of this report along with appeal rights were provided.


SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025
LIC9099 (FAS) - (06/04)
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