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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592599
Report Date: 05/18/2023
Date Signed: 05/18/2023 10:20:00 AM

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-20230425152443
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: 81DATE:
05/18/2023
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Assistant Administrator Marhlyn Sapugay TIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Uncleared adults providing care to residents
Staff inappropriately speak to residents
INVESTIGATION FINDINGS:
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On 05/18/2023 at 09:00 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted a subsequent complaint visit, to investigate the allegations listed above. LPA met with Assistant Administrator Marhlyn Sapugay and explained the reason for the visit.

During the initial 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.

During todays visit LPA interviewed staff S#4.
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: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
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-20230425152443
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: 05/18/2023
NARRATIVE
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The investigation reveals the following: Regarding " uncleared adults providing care to residents.", it is alleged that the facility has borrowed staff to work at the facility. The interview with the administrator confirmed the facility is short of staff, and they are borrowing staff from their sister facility. The administrator further stated all staff borrowed have staff files at the facility and they are also associated to the facility. 4 out of 4 staff denied the allegation, stating they are all associated to the facility. 9 out of 9 residents denied the allegation stating, they have not seen staff they believe to be uncleared working at the facility. LPA reviewed the facility roster and confirmed all staff, including borrowed staff are associated to the facility. LPA also reviewed facility files and confirmed all staff has a staff file located in the facility.

The investigation reveals the following: Regarding " Staff inappropriately speak to residents.", it is alleged that facility management uses foul language and yelled at the residents. During the interview, the Administrator denied the allegation, stating staff has never used foul language or yelled at the residents. The administrator further stated they have always encouraged the residents but have never yelled at the residents. 4 out of 4 staff denied the allegation stating they have never spoken to the residents inappropriately. 9 out of 9 residents denied the allegation stating that staff has never used foul language or disrespect them.

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 Assistant Administrator Marhlyn Sapugay 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: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2