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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592599
Report Date: 05/02/2024
Date Signed: 05/02/2024 02:56:35 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
04/15/2024 and conducted by Evaluator Christine Wong
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240415130948
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: 78DATE:
05/02/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Gil Martinez TIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Resident sustained an unexplained fracture while in care.
Illegal Eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Wong conducted a “Subsequent” visit to ascertain additional information regarding the above-mentioned allegation(s) and for the purpose of rendering the findings. LPA met with Staff #1 Facility Coordinator Ronaida Manzo who allowed entry into the facility and was later met by Assistant Administrator Erlinda Ramos and Administrator Gil Martinez who assisted with the visit.

The investigation consisted of the following: On 4/16/24, LPA conducted a health & safety check of clients in care. LPA observed a sufficient supply of perishable and non-perishable foods. LPA did not observe any immediate health and/or safety concerns for clients in care. The staff also provided LPA copies of requested documents. The following documents were obtained: Client#1 (C1) file documents (Physician's Report dated: 09/22/23, ID/Emergency Information and Appraisal Needs.) On today's date, LPA interviewed the administrator, three staff in the facility (S1-S3) and one staff (S4) via telephone and eight clients (C2-C8)in the facility and one client (C1) via telephone and obtained copy of clients and staff roster.
(See LIC 9099C for continuation)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
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-20240415130948
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: FOUNDERS HOUSE OF HOPE
FACILITY NUMBER: 191592599
VISIT DATE: 05/02/2024
NARRATIVE
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The investigation revealed of the following: Allegation#1 "Resident sustained an unexplained fracture while in care. " It's alleged that client went to the ER and complained of right foot pain and x-ray show it was a displaced fracture. LPA interviewed staff and it was reported client#1 (C1) twisted the ankle when C1 went to the bathroom and back to the bed and nurse immediately went to C1's room and checked on the C1 and saw C1's right food/ankle was swelling and in pain. The nurse called the ambulance and transported C1 to the hospital. LPA interviewed nine clients and nine out of nine clients and denied the allegation and reported they would able to get medical assistance or help in the facility when they were sick or not feeling well. LPA interviewed staff and all denied the allegation and reported they followed the protocol and staff would always ask client if they want to send to the hospital for further evaluation if they do not feel well.

Allegation#2 "Illegal Eviction" It's alleged that the hospital called the facility and administrator refused to take the client back. LPA interviewed the administrator and stated first of all, the facility had never given any eviction notice to client#1 (C1) or refused to take C1 back to the facility. Administrator stated due to C1's recent admission to the hospital and became non-ambulatory for temporary and facility only licensed for ambulatory clients. Administrator contacted C1's primary physician and indicated C1 required higher level of care for the current medical status. Therefore, C1 was sent to Skilled Nursing Facility for rehabilitation and C1 will be back to the facility when C1 is fully recovered. LPA interviewed clients and denied the allegation. The facility never gave any eviction notice to clients without a reason. LPA interviewed staff and denied the allegation and stated that the facility hasn't give out eviction notice to clients for a long time.

Based on the record reviewed and interviews conducted with staff and clients, 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 held. A copy of the report was provided to Administrator Gil Martinez.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2