<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601332
Report Date: 04/03/2023
Date Signed: 04/03/2023 04:08:19 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
03/14/2023 and conducted by Evaluator Elizabeth Hamilton
COMPLAINT CONTROL NUMBER: 08-AS-20230314085941
FACILITY NAME:ROYAL GARDEN GUEST HOMEFACILITY NUMBER:
374601332
ADMINISTRATOR:RODOLFO TABLADILLOFACILITY TYPE:
740
ADDRESS:39 G STREETTELEPHONE:
(619) 420-0830
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:6CENSUS: 4DATE:
04/03/2023
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee, Edna TabladilloTIME COMPLETED:
04:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not allow resident to make phone calls.
Staff did not allow resident to have visitors.
Licensee did not provide an adequate variety of food.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Elizabeth Hamilton conducted an unannounced complaint investigation visit at the facility. LPA was greeted at the front entrance by Licensee, Edna Tabladillo and granted entry after identifying herself. LPA explained the purpose of the visit which was to deliver findings for the above allegations.

The Department’s investigation consisted of record reviews, interviews with staff, residents and outside sources.

On March 14, 2023, it was alleged that staff did not allow resident to make phone calls. Specifically, it was alleged that the Licensee took resident 1’s (R1’s) personal cell phone so they could not make phone calls. Interviews with outside sources revealed R1 had a cellphone; however, R1’s responsible party removed the phone from their possession due to the amount of phone calls R1 made.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023
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-20230314085941
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: ROYAL GARDEN GUEST HOME
FACILITY NUMBER: 374601332
VISIT DATE: 04/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Interviews with R1 revealed they were able to use the facility telephone to make and receive phone calls. Interviews corroborated that all residents were able to use the facility phone.

On March 14, 2023, it was further alleged that staff did not allow resident to have visitors. Specifically, it was alleged that R1 was unable to have a friend visit due to the friend’s religious affiliation. Interviews with outside sources revealed that R1 was able to have visitors regardless of religious affiliation. Interviews with residents revealed that all residents were able to have visitors, and the only times visits were limited was during the COVID-19 pandemic. Interviews with staff revealed that residents were allowed visitors at the facility. Records reviewed confirmed visitors were admitted to the facility. Interviews with residents and outside sources confirmed no concerns with the visitor policy at the facility.

On March 14, 2023, it was also alleged that licensee did not provide an adequate variety of food. Specifically, it was alleged that residents had the same meal for breakfast, lunch and sometimes dinner. Interviews with multiple residents revealed that residents were given a variety of breakfast, lunch and dinner options which can interchange day to day. They are also given various snacks daily. Interviews further revealed meals included resident suggestions and preferences. Records reviewed revealed menu which confirmed meal variations. Interviews with residents, staff and outside sources confirmed there were no concerns with facility meals.

The Department has investigated the allegations listed above. Based on evidence obtained, including interviews and records reviewed, the above allegations are determined to be unsubstantiated as the Department could not meet the preponderance of the evidence standard.

An exit interview was conducted with Licensee Tabladillo and a copy of this report and Licensee/Appeals Rights (LIC 9058 01/16) was provided.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Elizabeth Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2