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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191222261
Report Date: 12/19/2022
Date Signed: 12/19/2022 12:41:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/16/2022 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20221216111332
FACILITY NAME:TRUDEZ HOME CAREFACILITY NUMBER:
191222261
ADMINISTRATOR:LOPEZ, WALDITRUDEZ P.FACILITY TYPE:
740
ADDRESS:15516 EL CAJON ST.TELEPHONE:
(818) 336-6537
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:6CENSUS: 5DATE:
12/19/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Waldi Lopez & Christina CalderonTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility did not follow COVID-19 protocols
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) conducted an unnanounced complaint visit, pertaining to the allegation mentioned above. LPA met with caregiver Christina Calderon, who was informed the reason of the visit. Staff Christina contacted Administrator Waldi Lopez, via telephone, who was not available to come to the visit. LPA spoke to the Administrator over the phone.

LPA arrived at the facility at 11am. LPA approached the front door and rang the door bell. LPA observed the signs posted on the door. Caregiver Christina allowed LPA to enter the facility. LPA observed a cleaning station, thermometer, and visitor sign book at the front door. LPA was allowed to enter, but temperature was not taken; nor was LPA requested to sign in the visitor book. From 11am to 1230pm, LPA conducted a physical plant inspection and interviewed staff and visitors. Administrator Waldi Lopez, reported to LPA, that at this time, due to the increase of COVID cases, the facility has limited visitation at the facility. Administrator reported, that staff are supposed to check temperatures and wear masks before entering the facility. During today's visit, LPA was allowed to enter, without any COVID screening procedur, and LPA observed staff to have face masks.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
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 3
Control Number 31-AS-20221216111332
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: TRUDEZ HOME CARE
FACILITY NUMBER: 191222261
VISIT DATE: 12/19/2022
NARRATIVE
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 Prior to the visit, LPA received information from a reliable source, that the facility does not practice any COVID procedures for visitors. Administrator confirmed that staff lack some of the COVID protocols, and will correct the issue. Therefore, based on interviews and observations, the allegation is SUBSTANTIATED.

Exit interview and copy of report provided.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20221216111332
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: TRUDEZ HOME CARE
FACILITY NUMBER: 191222261
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2023
Section Cited
CCR
87470(F)
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Infection Control: (F) Staff shall demonstrate knowledge of and skill in infection control, as appropriate to the job assigned and as evidenced by safe and effective job performance. This requirement was
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Administrator reported to LPA, that she will conduct in-service training to staff regarding visitor screening. LPA requesed documentation to be submitted by POC date
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not met, evidenced by: during today's complaint visit, staff did not COVID screen LPA before entering the facility. This is a potential health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3