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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374602294
Report Date: 12/20/2023
Date Signed: 12/20/2023 04:21:03 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
12/12/2023 and conducted by Evaluator Iby Strong
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20231212120348
FACILITY NAME:SILVERCREEK HOME CAREFACILITY NUMBER:
374602294
ADMINISTRATOR:MARIA LEBODAFACILITY TYPE:
740
ADDRESS:6530 BOON LAKE AVETELEPHONE:
(619) 464-3479
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY:6CENSUS: 3DATE:
12/20/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Caregiver Layla VisterTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Residents were exposed to inappropriate staff behavior.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation on the above-mentioned allegation. LPA identified herself and discussed the purpose of the visit with Layla Vister. Administrator Juancho Domingo arrived shortly after.

On December 12, 2023, Community Care Licensing (CCL) received a complaint alleging residents were exposed to inappropriate staff behavior. During investigation, LPA Strong collected pertinent resident records as well as facility documentation and conducted interviews. According to allegation, on November 20, 2023 at around 11:30pm, Staff 1 (S1) and Staff 2 (S2) were heard having sexual relations while residents were in care. Interview with residents revealed that there was no knowledge of such incident occurring. Interview with S1 and S2 revealed that no such incident occurred. Interview with outside source did not reveal any information to corroborate that this incident occurred. Additional interviews revealed that Resident 1 (R1) had recent increased sexual behaviors against staff and R1 moved out of facility in December 2023.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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-20231212120348
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: SILVERCREEK HOME CARE
FACILITY NUMBER: 374602294
VISIT DATE: 12/20/2023
NARRATIVE
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Based on LPA's interviews, and record reviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with Administrator Juancho Domingo, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Iby Strong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2