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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191502984
Report Date: 04/24/2023
Date Signed: 04/24/2023 12:24:23 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/17/2023 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230317153421
FACILITY NAME:SOUTHSIDE MANORFACILITY NUMBER:
191502984
ADMINISTRATOR:JAMES (GARY) PARDUEFACILITY TYPE:
735
ADDRESS:820 EAST GRAND AVENUETELEPHONE:
(909) 623-7305
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:38CENSUS: 26DATE:
04/24/2023
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Craig PardueTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Personal Rights: Staff sexually abused Client.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent complaint visit. The initial 10-day complaint visit was conducted on 03/21/2023. LPA met with Craig Pardue and explained the purpose of today's visit.

On 03/21/2023, LPA conducted a tour of this facility. LPA did not observe any signs of neglect, abuse or other immediate health and safety threats. LPA reviewed C-1's file and obtained relevant documentation. LPA obtained copies of the client and staff rosters.

Refer to LIC 9099C for the contunation of this report.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
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 28-AS-20230317153421
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SOUTHSIDE MANOR
FACILITY NUMBER: 191502984
VISIT DATE: 04/24/2023
NARRATIVE
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Allegation: Personal Rights: Staff sexually abused Client. During this investigation, Investigator Edward Hector interviewed C-1 and C-1’s Day Program Administrator at C-1’s Day Program. Interviews revealed that C-1’s “allegations of abuse were made up and untrue”. Per C-1’s interview, C-1 feels safe residing at this facility and “denied being touched in a sexual/inappropriate manner and reaffirmed, “I made it up”. LPA Irra interviewed Danielle Loboda (Assistant Administrator) and Craig Pardue (Administrator). Interviews revealed that Pomona Police Department arrived to this facility on 03/20/2023 and interviewed C-1 and C-1 indicated C-1 had fabricated this allegation. Interviews revealed that San Gabriel Pomona Regional Center also interviewed C-1 at C-1’s Day Program and C-1 also denied abuse. During today's visit, LPA confirmed with San Gabriel Pomona Regional Center that C-1 was interviewed and that C-1 had provided a false allegation and therefore their investigation was closed. Information gathered during this investigation does not corroborate this allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.



Exit interview conducted and appeal rights and a copy of this report was provided to Craig Pardue.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2