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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592599
Report Date: 11/07/2024
Date Signed: 11/07/2024 03:46:04 PM

Substantiated


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
10/31/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241031130529
FACILITY NAME:FOUNDERS HOUSE OF HOPEFACILITY NUMBER:
191592599
ADMINISTRATOR:JOSHUA LAJARAFACILITY TYPE:
735
ADDRESS:18025 PIONEER AVE.TELEPHONE:
(562) 860-3351
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY:98CENSUS: 78DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Josh Lajara/S-1TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Licensee not maintaining facility plumbing in good repair.

INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Elizabeth Irra and Mayra Cota conducted an initial visit to investigate the above allegations. LPA met with Josh Lajara/S-1 and discussed the purpose of today's visit.

During this visit, LPAs obtained the staff and resident rosters, copies of the menu, plumbing invoices and hot food temperature logs. LPAs reviewed client files (including Personal and Incidental/P&I) and obtained relevant information. LPAs also interviewed Staff #1 (S-1) through Staff #5 (S-5), interviewed Resident #1 (R-1) through Client #7 (R-7) and conducted a tour.

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

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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 6
Control Number 28-AS-20241031130529
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: 11/07/2024
NARRATIVE
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Licensee not maintaining facility plumbing in good repair. It was alleged that the facility's plumbing is in disrepair and there is no hot water. Staff interviews revealed that this facility is undergoing plumbing repairs since October 2024 and not all residents are receiving hot water. Interviewed staff indicated there are (2) vacant designated bedrooms which are being used for residents to take hot showers. Residents’ interviews indicated that the facility has not had hot water for approximately (1) month. Interviewed clients indicated that there are (2) communal bathrooms (1 is assigned for females and 1 is assigned for males) that have hot water supply for showers. LPAs toured the facility and observed signs posted (signs dated 10/08/24 and 10/21/24) which reflect the issues of the facility not having hot water. Per posted sign dated 10/21/24, the facility is “temporarily offering a shared restroom for hot water” and residents are to ask the medication team or housekeeping to open the door. This posted sign also indicates “only one person can use the restroom at a time”. Interviews and tour corroborate this allegation.

Based on LPA's observation and interviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

California Code of Regulations, title 22 are being cited on the attached LIC 9099D

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

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 28-AS-20241031130529
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/08/2024
Section Cited
CCR
80087(a)
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Buildings and Grounds (a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This standard is not met as evidence by:
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Administrator to submit a written statement as to how this facility will provide additional hot water supply to residents and submit this plan to LPA Irra by 11/08/2024.
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Per staff and resident interviews, this facility has been undergoing plumbing repairs since October 2024 and not all residents are receiving hot water supply for residents to shower.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
10/31/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241031130529

FACILITY NAME:FOUNDERS HOUSE OF HOPEFACILITY NUMBER:
191592599
ADMINISTRATOR:JOSHUA LAJARAFACILITY TYPE:
735
ADDRESS:18025 PIONEER AVE.TELEPHONE:
(562) 860-3351
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY:98CENSUS: 78DATE:
11/07/2024
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Josh Lajara/S-1TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Licensee not ensuring there is at least one facility staff on the premises and awake at night
Facility staff not providing quality meals to residents
Facility staff not providing Personal and Incidental Needs Allowance to resident
Facility staff not safeguarding resident's belongings
Facility staff not preventing altercations between residents
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Elizabeth Irra and Mayra Cota conducted an initial visit to investigate the above allegations. LPA met with Josh Lajara/S-1 and discussed the purpose of today's visit.

During this visit, LPAs obtained the staff and resident rosters, copies of the menu, plumbing invoices and hot food temperature logs. LPAs reviewed client files (including Personal and Incidental/P&I) and obtained relevant information. LPAs also interviewed Staff #1 (S-1) through Staff #5 (S-5), interviewed Resident #1 (R-1) through Client #7 (R-7) and conducted a tour.

Refer to LIC 9099C for the continuation 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: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 28-AS-20241031130529
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: 11/07/2024
NARRATIVE
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Licensee not ensuring there is at least one facility staff on the premises and awake at night It was alleged that night-time shift (NOC) staff (S-5) sleeps at night during their shift and he is the only staff on the premises. Staff interviews the night-time staff (NOC) (including S-5) are awake during their shift. Interviewed staff indicated they have not heard anyone complaining about the night-time staff being asleep during their shift. Resident interviews revealed the night-time staff (NOC) (including S-5) are awake during their shift. Interviewed residents indicated they have not heard anyone complaining about the night-time staff being asleep during their shift. Interviewed residents indicated they do not have any concerns. Interviews do not corroborate this allegation.

Facility staff not providing quality meals to residents It was alleged that staff are not providing quality meals to residents. Staff interviews revealed the facility provides quality meals to residents. Staff interviews revealed that residents are provided with warm meals and that staff follow a menu (developed and reviewed by a dietitian). Staff also offer substitutions upon request. Per record review, kitchen staff also maintain a temperature log for hot foods for each meal. Interviewed staff indicated they have not heard anyone complaining about this matter. Resident interviews revealed that the facility provides quality meals and that the food served is warm. Interviewed residents did not have any concerns about the meals provided by this facility. Interviewed clients indicated they have not heard anyone complaining about this matter. Interviews do not corroborate this allegation.

Facility staff not providing Personal and Incidental Needs Allowance to resident It was alleged that Personal and Incidental Allowance (P&I) money has not been received "for months". Staff interviews revealed that clients receive their P&I monies on Tuesdays and the disbursements are documented on the resident logs. Interviewed staff indicated that the Administrator and Assistant Administrator handle the P&I monies. Interviewed staff indicated that they have not received any complaints regarding this matter. Resident interviews revealed that they receive their P&I monies every Tuesday and have not concerns. Interviewed Residents indicated that they have not heard anyone complaining about this matter. Interviews and P&I log review does not corroborate this allegation.

Refer to LIC 9099C for the continuation of this report.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 28-AS-20241031130529
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: 11/07/2024
NARRATIVE
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Facility staff not safeguarding resident's belongings It was alleged that other residents have stolen cigarettes and dress shirts from another resident. Interviewed staff indicated that they have not received any complaints regarding this matter. Per resident file reviews, staff maintain records of the residents personal belongings and also have a facility theft and loss program document on file. Interviewed residents indicated that they do not have any concerns regarding this matter and that their belongings are safeguarded. Interviews and file review does not corroborate this allegation.

Facility staff not preventing altercations between residents It was alleged that staff are not preventing altercations between residents. Per S-1 interview, the most recent resident altercation occurred in August 2024 which was reported to Community Care Licensing (CCL). Per incident report, staff took proper measures to address this matter. Staff interviews revealed that there has not been any recent alterations between residents. Interviewed staff indicated they have not received any complaints regarding this matter. Resident interviews revealed that residents have not been involved in altercations nor have they heard anyone complaining about this matter. Interviews do not corroborate this allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted, a copy of the Appeal Rights and this report was provided to Josh Lajara
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6