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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604439
Report Date: 05/07/2024
Date Signed: 05/07/2024 11:46:28 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2024 and conducted by Evaluator Stephanie Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240503152327
FACILITY NAME:KELLY'S CEDAR VILLAFACILITY NUMBER:
374604439
ADMINISTRATOR:WELKER, GARRETTFACILITY TYPE:
740
ADDRESS:1341 BOYLE AVENUETELEPHONE:
(619) 504-5049
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:6CENSUS: 6DATE:
05/07/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Garrett Welker, AdministratorTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Facility heater is in disrepair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst, Stephanie Martinez, conducted an unannounced visit to the facility to start the investigation into the above allegation. The LPA met with Administrator, Garrett Welker, and informed him of the purpose for her visit. A report was received by the Department alleging the facility heater had been broken for about one week and the temperature in the home was cold for a resident in care. The visit included staff and resident interviews, a review of records and collection of relevant documentation. Administrator Welker was interviewed and confirmed the furnace in the home was in disrepair and, as a result, no heat was available to warm the home. Staff and resident interviews confirmed the furnace was broken; however, they reported it was repaired today, 05/07/2024. Staff interviews reported the furnace was in disrepair for about one week. Resident interviews reported the furnace was in disreapair for about one to three weeks. All interviews reported staff made attempts to accomodate residents by providing portable heaters and extra blankets. No resident interviews reported staff were neglectful with regard to keeping the home comfortable during the time the furnace was in disrepair. Therefore, based on interviews, this allegation is deemed UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. This report was reviewed with Administrator Welker and a copy was provided.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Stephanie Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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