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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604388
Report Date: 12/04/2024
Date Signed: 12/09/2024 12:19:55 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
06/20/2024 and conducted by Evaluator Amy Domingo
COMPLAINT CONTROL NUMBER: 08-AS-20240620145410
FACILITY NAME:SUNSET CLIFFS ELDER CAREFACILITY NUMBER:
374604388
ADMINISTRATOR:TRAVONNA WASHINGTONFACILITY TYPE:
740
ADDRESS:1039 SANTA BARBARA STREETTELEPHONE:
(619) 791-5495
CITY:SAN DIEGOSTATE: CAZIP CODE:
92107
CAPACITY:6CENSUS: 6DATE:
12/04/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Co-Administrator Guarav “Gary” RathiTIME COMPLETED:
04:09 PM
ALLEGATION(S):
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Staff are allowing a child to care for residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Amy Domingo conducted an unannounced visit to initiate an investigation on the above-mentioned allegations. LPA identified herself and discussed the purpose of the visit with Guarav “Gary” Rathi, Co-Administrator.

On June 20, 2024, Community Care Licensing (CCL) received a complaint alleging staff are allowing a child to care for residents in care. During the investigation, LPA Domingo collected pertinent resident records as well as facility documentation and conducted interviews with residents and staff.


Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
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-20240620145410
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: SUNSET CLIFFS ELDER CARE
FACILITY NUMBER: 374604388
VISIT DATE: 12/04/2024
NARRATIVE
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Continued from LIC9099


According to allegation, the staff are allowing a child to care for residents in care. According to staff interviews, the staff do not allow a child to care for the residents in care. Staff have stated that there are volunteers of different age groups that provide activities such as puzzles, art projects, entertainment and visits with the residents.  

Interview with residents' revealed that there is a younger person that visits with the residents and helps them with puzzles, they listen to music and watch tv.  There are other visitors that provide entertainment such as singing and dancing during the holiday season.  The residents stated that there has not been any child rendering care or assisting the caregivers with care giving needs for the residents. Two of the residents need adult caregivers due to the inability of the resident to assist with turning from side to side.

Interviews with outside sources also confirmed that there is younger person that lives with the caregiver at the facility but the younger person was not seen rendering care to any of the residents.  The outside sources confirmed that the younger person has been seen reading books, watching tv, and playing games/puzzles with the residents.  

Based on LPA's interviews, observations 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 Guarav “Gary” Rathi, Co-Administrator. 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: Amy Domingo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2