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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604690
Report Date: 04/23/2025
Date Signed: 04/23/2025 12:53:33 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
01/14/2025 and conducted by Evaluator Angelica Boyles
COMPLAINT CONTROL NUMBER: 08-AS-20250114160512
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:
04/23/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Assistant Administrator Sarita MendozaTIME COMPLETED:
12:55 PM
ALLEGATION(S):
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Staff are financially abusing client in care
Facility is failing to meet the needs of client
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Angelica Boyles conducted an unannounced visit to deliver investigative findings regarding the above-mentioned allegations. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Assistant Administrator Sarita Mendoza.

The Department’s investigation consisted of interviews with staff, residents, and outside sources, records review of relevant documents pertinent to this investigation, and LPA observations. On January 14, 2025, it was alleged that the facility staff were financially abusing Resident #1 (R1) [See LIC811 Confidential Name List for a description of select person identifiers used in this report] and facility staff were failing to meet R1's needs.

(Continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
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-20250114160512
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: 04/23/2025
NARRATIVE
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Regarding the allegation of financial abuse, LPA interview with R1 did not corroborate this allegation. R1 did confirm going to the bank with facility staff once, but reported it was to change mailing address after moving to the facility. LPA interview with staff aligned with R1's report of visiting the bank.

Regarding the allegation of R1's needs not being met, LPA did not observe R1 to be in soiled clothing or smelling bad. LPA observations did not indicate that resident's needs were not being met. While records reviewed did indicate R1 might require occasional minor assistance, R1 reported being fully independent and not requiring staff assistance with activities of daily living. R1 reported being comfortable asking for help if and when needed.

Further, LPA interview of an outside source familiar with the facility did not express any concerns regarding both above mentioned allegations.

The Department has investigated the allegations that staff are financially abusing client in care and facility is failing to meet the needs of client. Based upon the information obtained during this investigation, it is determined that the preponderance of evidence was not met to support or corroborate these allegations and therefore deemed unsubstantiated.

The report was discussed, and an exit interview was conducted with Assistant Administrator Sarita Mendoza. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided at the conclusion of the visit. The signature below confirms the receipt of these documents.
SUPERVISORS NAME: Simon Jacob
LICENSING EVALUATOR NAME: Angelica Boyles
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2