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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191200236
Report Date: 03/29/2024
Date Signed: 03/29/2024 11:38:48 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CRP RO, 300 N. CONTINENTAL BLVD. #290B
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/14/2024 and conducted by Evaluator Deborah Lee
COMPLAINT CONTROL NUMBER: 34-CR-20240214165903
FACILITY NAME:FIVE ACRESFACILITY NUMBER:
191200236
ADMINISTRATOR:CRANE, SHANNONFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:16CENSUS: 13DATE:
03/29/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Shontel Davis, Crisis Interviention speciallistTIME COMPLETED:
11:30 PM
ALLEGATION(S):
1
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9
Staff do not treat minors fairly.
Staff do not ensure that minors are afforded proper grooming services.
Staff inappropriately restrain minor.
INVESTIGATION FINDINGS:
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5
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9
10
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13
On March 29 2024 at 11:00 AM Licensing Program Analyst (LPA) Deborah Lee made an unannounced inspection to Five Acres for the purpose of concluding the investigation of the above allegations and to deliver the findings. LPA spoke with Shontel Davis,and discussed the investigative findings together.

During the investigative process, LPA conducted a total of 5 confidential interviews (3 staff and 2 clients), obtained supporting documents, and conducted a record review.

According to complaint, client #1 (C1) alleges that staff does not ensure that minors are afforded proper grooming services, and staff do not treat minors fairly. However through the investigative process it was revealed that the facility has paid for a professional stylist to provide services to meet client’s grooming needs. Additionally, C1 and C2 admitted that they receive adequate grooming services and hair care products at the facility.
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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bernice Karnsrithong
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024
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 34-CR-20240214165903
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CRP RO, 300 N. CONTINENTAL BLVD. #290B
EL SEGUNDO, CA 90245
FACILITY NAME: FIVE ACRES
FACILITY NUMBER: 191200236
VISIT DATE: 03/29/2024
NARRATIVE
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 Through a confidential interview, S2 informed LPA that clients in care have input in the selection of their preferred hair care products that the facility purchase.

Lastly, there is no corroboration of the allegation that staff inappropriately restrained minor.

Based on information obtained, the allegations are found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations.

Exit Interview conducted, and a copy of this report will be emailed to Claudia Rice Division Director.

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SUPERVISORS NAME: Bernice Karnsrithong
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024
LIC9099 (FAS) - (06/04)
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