015601410-4-30-2020-15-AS-HHUL-BRDT8V-20200710143057

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 015601410
Report Date: 04/30/2020
Date Signed: 04/30/2020 02:21:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/21/2020 and conducted by Evaluator Alicia Delmundo

COMPLAINT CONTROL NUMBER: 15-AS-20200421161535

FACILITY NAME:	ARCADIAN RESIDENTIAL COMMUNITY		FACILITY NUMBER:	015601410
ADMINISTRATOR:	NELSON MASAYA		FACILITY TYPE:	740
ADDRESS:	24647 MOHR DRIVE		TELEPHONE:	(510) 887-8898
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94545
CAPACITY:	38	CENSUS: 38	DATE:	04/30/2020
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Licensees Wendy Wong and Olive Manalastas		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Individual (IND) allowed to care for residents without a criminal record clearance.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Delmundo called and spoke with Wendy Wong, licensee, in order to meet the 10-day requirement for notification of the above allegation. LPA also spoke with Olive Manalastas, licensee. LPA explained that the reason for the call is to inform that a complaint has been received. LPA further explained that due to the present shelter in place order, the notification is done over the phone. LPA also met and spoke over the phone with Administrator Nelson Masaya and Assistant Administrator Lulin 'Lucy' Wu.

LPA obtained copies of resident's (R1) following documents: LIC601 Identification and Emergency Information; Physician's Report; Appraisal/Needs and Services Plan; written note; Incident Report.

LPA conducted interviews through video communication.

......continued on 9099C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Isaac Taggart	TELEPHONE: (510) 363-5912
LICENSING EVALUATOR NAME: Alicia Delmundo	TELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020

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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Control Number 15-AS-20200421161535

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: ARCADIAN RESIDENTIAL COMMUNITY	FACILITY NUMBER: 015601410
	VISIT DATE: 04/30/2020

NARRATIVE

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It was alleged that an individual (IND) became friends with the licensees. Licensees allowed IND performed therapy for free for residents. IND who is not fingerprinted and cleared comes to the facility almost everyday to provide service.

LPA interviewed Olive Manalastas who stated that IND always brought his dogs for therapy for the residents and IND was always with staff when he's around. Licensee Wendy Wong stated that IND used to visit his sister at the time when his sister was at the facility. IND became friends with the residents. IND came to the facility with his dogs to visit residents even after the sister had moved out. Staff (S1, S2 and S3) were
interviewed who stated IND comes to the facility to visit and talk to the residents. IND became friends with the residents and brought his dogs when he visited.

Residents (R1, R2 and R3) were interviewed. R1 stated she does not know IND while R2 said IND visited her as a friend. R3 confirmed that IND never performed therapy to the residents but came and visited with his dogs.

LPA checked the California Board of Behavioral Sciences website and confirmed that IND is a Licensed Marriage and Family Therapist (LMFT). LPA confirmed with IND who indicated he came to the facility with his dogs. IND indicated he performed therapy for free for residents and that he spent approximately only four (4) hours a week.

Based on all the information obtained and that due to IND spent and provided only four (4) hours a week of free service to the residents and staff was with him when he's at the facility, and he's an LMFT, IND does not need to be fingerprinted and cleared. Therefore, the allegation is closed as unfounded. The complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis, therefore the complaint is dismissed.

Exit interview conducted and copy of this report provided via e-mail. LPA requested the license to sign this report and return a copy to LPA.

SUPERVISOR'S NAME: Isaac Taggart	TELEPHONE: (510) 363-5912
LICENSING EVALUATOR NAME: Alicia Delmundo	TELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020

LIC9099 (FAS) - (06/04)

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