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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592599
Report Date: 09/23/2022
Date Signed: 09/23/2022 03:57:50 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, 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
09/21/2022 and conducted by Evaluator Bonnie Tao
COMPLAINT CONTROL NUMBER: 28-AS-20220921135922
FACILITY NAME:FOUNDERS HOUSE OF HOPEFACILITY NUMBER:
191592599
ADMINISTRATOR:CRYSEL SANTOSFACILITY TYPE:
735
ADDRESS:18025 PIONEER AVE.TELEPHONE:
(562) 860-3351
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY:98CENSUS: 75DATE:
09/23/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Marhlyn Sapugay, administrator assistant.TIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Facility is not adequately feeding residents while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tao, conducted unannounced complaint investigation for the allegation listed above today. During today’s visit, LPA met administrator assistant, Marhlyn Sapugay. LPA explained the purpose of today's visit regarding the above-mentioned allegation.

Investigation consisted of the following: interviews of staff from Staff #1 (S1) through Staff #6 (S6); interviews of clients from Client#1 (C1) through Client #5 (C5); reviewed facility dietary record and a facility tour. LPA obtained copies of the Staff and Client Rosters; and clients’ dietary records with relevant information.

The investigation revealed the following: In regard to allegation, “facility is not adequately feeding residents while in care," it was alleged that facility did not feed clients adequately and allowed staff to pack client’s excessive orders of food home. Five (5) out of five (5) clients could not corroborate the allegation.
(-continued in LIC 9099 C-)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
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 2
Control Number 28-AS-20220921135922
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: FOUNDERS HOUSE OF HOPE
FACILITY NUMBER: 191592599
VISIT DATE: 09/23/2022
NARRATIVE
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Client interviews from C1 through C5 revealed that clients did not see staff taking clients’ food home and staff would check on clients to ensure clients were fed adequately. Six (6) out of six (6) staff denied the allegation. Staff interviews revealed staff were not allowed to take clients’ food home. Staff said clients’ excessive, un-served food would be stored in kitchen’s refrigerators and use it in the next meal. Staff said they would pack the leftover food in trash bags and take them out to the trash bin after each meal. File review revealed clients’ menu was set by a certified dietitian, which was written on a dietary report. Facility food purchase list was based on dietitian report. LPA did not observe staff packed clients’ food and took the food home during the visit.

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.

No deficiencies are being cited according to California Code of Regulations, Title 22, Division 6, Chapter 8.

An exit interview was conducted with administrator assistant, Marhlyn Sapugay. A hard copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2