191592599-5-4-2023-28-AS-LHIS-CRUS6S-20230515133622

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191592599
Report Date: 05/04/2023
Date Signed: 05/04/2023 03:00:54 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
04/25/2023 and conducted by Evaluator Jewel Baptiste

COMPLAINT CONTROL NUMBER: 28-AS-20230425100208

FACILITY NAME:	FOUNDERS HOUSE OF HOPE		FACILITY NUMBER:	191592599
ADMINISTRATOR:	CRYSEL SANTOS		FACILITY TYPE:	735
ADDRESS:	18025 PIONEER AVE.		TELEPHONE:	(562) 860-3351
CITY:	ARTESIA	STATE: CA	ZIP CODE:	90701
CAPACITY:	98	CENSUS: 81	DATE:	05/04/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Administrator Crysel Santos		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff mishandling residents medication.
Staff did not administer medication(s) as prescribed.
Staff cancelling residents doctors appointments due to short staffing.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 05/04/2023 at 09:00 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted two (2) 10-day complaints in conjunction, to investigate the allegations listed above. LPA met with Administrator Crysel Santos and explained the reason for the visit.

During today’s visit LPA and the Administrator toured the Kitchen, dining room, reviewed medications and conducted file review for staff # 1 through 3. LPA obtained resident/ staff roster, staff schedule and Administrator and Staff training on medication administration. LPA also interviewed: Administrator and a total of two (2) staff who shall be referred to as S1, and S2. LPA interviewed a total of 9 residents who shall be referred to as: R2 through R10, R1 was not in the facility to interview. Medications was reviewed for residents R1 through R3.

Report continued on 9099c

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

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-20230425100208

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: 05/04/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The investigation reveals the following: Regarding " Staff mishandling residents’ medication.", it is alleged that the facility staff provided residents with other resident’s medication. During the interview the Administrator denied the allegation. 7 out of 9 residents denied the allegation, stating that staff has never provided them with the wrong medications. 1 out of 9 residents stated that they were provided with extra medications but that was an error from the pharmacy. 1 out of 9 residents stated that they were provided with another resident’s medication, in the past. 1 out of 2 staff denied the allegation, stating they have not provided the wrong medications to residents. 1 out of 2 staff stated they do not work in the medication room.

The investigation reveals the following: Regarding " Staff did not administer medication(s) as prescribed.", it is alleged that the facility is administering the medications late. During the interview the Administrator denied the allegation, stating the facility provides the residents medication within the 1-hour window and has never administered the medications late. 9 out of 9 residents denied the allegation stating that staff has never provided them with late medications. 1 out of 2 staff stated the medications was administered on-time. 1 out of 2 staff stated they do not work in the medication room.

The investigation reveals the following: Regarding " Staff canceling residents doctors’ appointments due to short staffing.", it is alleged that the facility was canceling residents’ doctors’ appointments. During the interview the Administrator denied the allegation, stating the facility has never canceled the residents’ doctors’ appointments. 9 out of 9 residents denied the allegation stating that staff has never canceled their doctors’ appointments. 1 out of 2 staff stated they have never canceled the resident’s doctor’s appointment and leave pass downs to the other staff indicating residents’ doctors’ appointments. 1 out of 2 staff stated they do not handle residents’ doctors’ appointments.

Based on LPA's observation, interviews, and file review the investigation revealed: 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 allegations are UNSUBSTANTIATED.

Exit interview conducted with Administrator Crysel Santos and a copy of this record provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2