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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191592599
Report Date: 08/06/2024
Date Signed: 08/06/2024 02:32:15 PM


Document Has Been Signed on 08/06/2024 02:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 HOPEFACILITY NUMBER:
191592599
ADMINISTRATOR:JAZELLE TURCATOFACILITY TYPE:
735
ADDRESS:18025 PIONEER AVE.TELEPHONE:
(562) 860-3351
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY:98CENSUS: 83DATE:
08/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Assistant Administrator Erlinda RamosTIME COMPLETED:
02:47 PM
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On 8/6/2024, Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced case management visit to follow up on the incident report and SOC 341 submitted by the facility dated 8/2/2024. The incident is regarding a client-on-client altercation. On 8/2/2024 the Administrator also called CCLD, and another SOC 341 was created for the incident. LPA met with Erlinda Ramos, Assistant Administrator and explained the reason for the visit.

During the visit, LPA interviewed the Assistant Administrator and a total of 1 staff (S1). Client #1 is currently hospitalized, and LPA interviewed Client #2. A copy of the Staff roster, Client roster, SOC341 and Unusual incident report was obtained.

According to SOC 341 and Incident report, it is alleged that on 7/28/2024, C1 threaten to kill C2 (roommate) with a screwdriver. According to C2 the incident did not get physical, but C1 was yelling. The Assistant Administrator stated C1’s public Guardian is relocating C1 due to needing a higher level of care. Further follow up maybe necessary.

Exit interview conducted with the Assistant Administrator Erlinda Ramos, and a copy of this report was given.

SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel BaptisteTELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:
DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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