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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604690
Report Date: 11/13/2024
Date Signed: 11/13/2024 01:14:43 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
11/04/2024 and conducted by Evaluator Renita Hall
COMPLAINT CONTROL NUMBER: 08-AS-20241104154720
FACILITY NAME:CARROLL'S RESIDENTIAL CAREFACILITY NUMBER:
374604690
ADMINISTRATOR:MEYERS, BRYANFACILITY TYPE:
740
ADDRESS:655 S MOLLISON AVETELEPHONE:
(619) 444-3181
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:144CENSUS: 127DATE:
11/13/2024
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Bryan Meyers, Administrator and
Sarita Mendoza, Administrative Assistant		TIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not keep facility free of insects.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced visit regarding the above-mentioned allegation. LPA was allowed entry by Brian Meyers, Administrator. LPA identified herself and disclosed the purpose of the visit and elements of the complaint with Brian Meyers and Sarita Mendoza, Administrative Assistant.

The Department investigated the above-listed complaint allegation. The investigation consisted of a tour of the facility, interviews with staff, and residents, and a records review, including other relevant evidence pertinent to this investigation such as the Pest Control maintenance contract agreement and Inspection Reports.

On November 4, 2024, Community Care Licensing (CCL) received a complaint alleging that the Licensee did not keep the facility free from insects. The facility has had a service contract with Orkin since 2002 for monthly pest control treatment with previous treatments on September 24, 2024, and October 29, 2024
{Continued on 9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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-20241104154720
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: CARROLL'S RESIDENTIAL CARE
FACILITY NUMBER: 374604690
VISIT DATE: 11/13/2024
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
As of October 29, 2024, Orkin Pest Control provided services to several residents' rooms that included crack and crevice preventative maintenance of German roach activity. On November 13, 2024, LPA’s observation; room inspection revealed no remnant of roaches or other insects. Residents interviewed all stated that they did not have roaches or other insects at the time of the visit.

Based on observations, interviews with residents, and a review of pertinent pest control inspection reports, there was insufficient evidence found to support the allegation that the Licensee did not keep the facility free of insects. Due to a lack of evidence, the allegation is deemed to be unsubstantiated. A finding that is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Sarita Mendoza, Administrative Assistant. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Administrative Assistant and her signature on this report confirms receipt of the Licensee Rights.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2