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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 372004864
Report Date: 06/28/2022
Date Signed: 06/28/2022 02:57:32 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, 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
05/09/2022 and conducted by Evaluator Iby Strong
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20220509175449
FACILITY NAME:ROSE GARDEN GUEST HOMEFACILITY NUMBER:
372004864
ADMINISTRATOR:JILL MCCLUREFACILITY TYPE:
740
ADDRESS:6881 MEWALL DRIVETELEPHONE:
(619) 465-7036
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY:5CENSUS: 5DATE:
06/28/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Caregiver Josefina EliangTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Facility is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to deliver findings in the above complaint allegation. LPA identified herself and discussed the purpose of the visit with Caregiver Josefina Eliang.

On May 9, 2022, Community Care Licensing received a complaint alleging facility is in disrepair. During LPA Strong’s facility inspection on May 13th, 2022, LPA saw facility had a large plastic cover over the roof that was not in good repair. Through staff interviews and outside source interviews, LPA Strong found that the Licensee was actively working on fixing a leaking roof. The plastic cover was placed over the roof by the roofing company in February of 2022. This action was done to prevent further leaks while the roofing company and solar panel company agreed on a project start date. An invoice dated April 20, 2022 shows a monetary deposit was made by Licensee to remove solar panels from roof. Email communications between both companies and Licensee also verify the roofing company had established a project start date of May 31, 2022.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
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-20220509175449
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ROSE GARDEN GUEST HOME
FACILITY NUMBER: 372004864
VISIT DATE: 06/28/2022
NARRATIVE
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Further assessment of the facility by LPA Strong showed no health or safety risk to the residents in care. Based on the evidence found the Licensee acted promptly in fixing roof.

Based on LPA's interviews, observations, and records reviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with Caregiver Josefina Eliang, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 01/16) were provided.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2