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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600488
Report Date: 01/06/2026
Date Signed: 01/06/2026 03:52:14 PM

Unfounded


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
10/22/2025 and conducted by Evaluator Arian Golbakhsh
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20251022140438
FACILITY NAME:CASA DE LAS CAMPANASFACILITY NUMBER:
374600488
ADMINISTRATOR:HARRIS, BROOKEFACILITY TYPE:
741
ADDRESS:18655 WEST BERNARDO DRIVETELEPHONE:
(858) 451-9152
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY:582CENSUS: 505DATE:
01/06/2026
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Residential Administrator Tyre RichardsTIME COMPLETED:
03:55 PM
ALLEGATION(S):
1
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9
Lack of supervision.
INVESTIGATION FINDINGS:
1
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5
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13
Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced visit to deliver findings for a complaint investigation regarding the above mentioned allegation. LPA was welcomed by, identified themselves to, and discussed the purpose of their visit to Residential Administrator Tyre Richards.

On 10/22/2025, the Department received a complaint where it was alleged that a private caregiver for a resident at the facility was clocking in for shifts at the facility they were not physically present for. Per the complaint, this had been going on for a period of three (3) weeks. The Department’s investigation consisted of unannounced facility visits, records review, and interviews with staff and outside sources.

[Continued on LIC 9099-C]
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
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-20251022140438
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 DE LAS CAMPANAS
FACILITY NUMBER: 374600488
VISIT DATE: 01/06/2026
NARRATIVE
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32
[Continued from LIC 9099]

Per records review of admission/discharge records for R1, it was revealed that R1 had been residing in the SNF for over a year and a half, pre-dating the timeline of the complaint. The Department has no jurisdiction in Skilled Nursing Facilities (SNFs) as they are regulated by the Department of Public Health, therefore there is no indication of a violation of Community Care Licensing Regulations. Review of facility staff association records did not reveal any matches to the caregiver named in the complaint.

The agency has investigated the complaint alleging lack of supervision. We have determined that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have dismissed the complaint. An exit interview was conducted with Residential Administrator Richards to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.
SUPERVISORS NAME: Sabel Martinez
LICENSING EVALUATOR NAME: Arian Golbakhsh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2