191290706-7-6-2023-31-AS-EMIR-CU5V2U-20230727160340

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290706
Report Date: 07/06/2023
Date Signed: 07/06/2023 02:33:21 PM

Unsubstantiated

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
06/26/2023 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20230626162028

FACILITY NAME:	HAMILTON HOUSE		FACILITY NUMBER:	191290706
ADMINISTRATOR:	PETERSON, JANICE		FACILITY TYPE:	735
ADDRESS:	739 W. GLENOAKS BLVD.		TELEPHONE:	(818) 502-9188
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91202
CAPACITY:	11	CENSUS: 9	DATE:	07/06/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Carlos Correa, Kathy Solorzano		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility mismanages client(s) cash resources.
Staff retaliated against client in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. LPA met with staff, Kathy Solorzano and advised her of the complaint. The administrator, Carlos Correa arrived shortly after. Today's investigation consisted of interviews with residents and staff between 9:15am to 11:00am. LPA conducted a record review between 11:30am to 12:30pm. Between 12:30pm-1:30pm, a physical plant inspection was made to insure the health and safety of the residents in care.

Facility mismanages resident(s) resources:
In regards to the allegation, it was reported that Resident 1's (R1) Personal and Incidental (P&I) are often disbursed late, typically after all the other residents. In addition, the amount of P&I being disbursed varies. Interviews reveal that P&I checks are usually received every 15th of the month. Once received, it gets disbursed right away to them. Interviews reveal no complaints from the other three residents, who's P&I the facility handles, of getting their money late. In regards to why at times the amount varies, the administrator

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

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 31-AS-20230626162028

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: HAMILTON HOUSE	FACILITY NUMBER: 191290706
	VISIT DATE: 07/06/2023

NARRATIVE

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stated that there are times when Regional Center (RC)does an audit, a resident may have either been over or under paid. RC would have to make up the difference on the resident's next check. LPA conducted a review of Resident Fund Records and observed that funds are received by the facility anywhere between the 12th and 17th of each month. No other discrepancies were observed. Based on the information obtained, there was insufficient evidence to prove that the facility mismanages the client's cash resources. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff retaliated against resident in care:
In regards to the allegation, it's being alleged that because Resident 1 (R1) reported an infestation of bed bugs and rodents, the administrator has been retaliating towards R1 by distributing their P&I checks late, and forcing R1 to get up at 8am every morning to shower and take care of their hygine needs, which is earlier than the other residents. Interviews with staff and residents do not corroborate with the allegation. The facility is a level II home where residents are independent enough to get up on their own and conduct their own hygiene and personal needs with minimal to no prompting. R1 is independent and able to care for self with some occasional reminders. In regards to R1's P&I check, funds are received from Regional Center through mail between the 12th and 17th of each month. Interview with residents deny them getting their checks late. Review of the Resident Fund Records indicate that checks are received anywhere between the 12th and 17th of every month. No other discrepancies observed. Based on the information obtained, there was insufficient evidence to prove that staff retaliated against the resident in care. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023

LIC9099 (FAS) - (06/04)

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