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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592599
Report Date: 11/17/2021
Date Signed: 11/17/2021 02:51:05 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
07/23/2021 and conducted by Evaluator Nina Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20210723104020
FACILITY NAME:FOUNDERS HOUSE OF HOPEFACILITY NUMBER:
191592599
ADMINISTRATOR:YNA BARNESFACILITY TYPE:
735
ADDRESS:18025 PIONEER AVE.TELEPHONE:
(562) 860-3351
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY:98CENSUS: 83DATE:
11/17/2021
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Crysel SantosTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not safeguard client's belongings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/17/2021 Licensing Program Analyst (LPA) Nina Galarza conducted an unannounced subsequent complaint visit regarding the allegation listed above. LPA met with Administrator Crysel Santos and explained the reason for the visit.

The investigation consisted of: On 11/5/2021, interviews with Assistant Administrator, S1 and Clients 1-7 (C1-C7). LPA obtained copies Client roster, Staff roster, facility theft and loss program and inventory list for Clients 1-8 (C1-C8) . On 11/17/2021 interviews with Administrator and Clients 9-13 (C9-C13). LPA obtained copies of staff roster, client roster, and Release of Liability and Disclaimer dated August 2021.


CONTINUED 9099-C

Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Nina Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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-20210723104020
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: 11/17/2021
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
Allegation: " Staff did not safeguard Client's belongings". LPA reviewed C1-C8's files and observed that all clients had a completed personal property and valuables inventory list. On 11/5/2021 Assistant Administrator Dana Ordonez and S1 denied the allegation. On 11/17/2021 Administrator Crysel Santos denied the allegation. On 11/5/2021 Assistant Administrator stated if a client were to lose something, the facility would replace it. On 11/17/2021 Administrator Crysel Santos stated if a client were to lose something, the facility would replace it. On 11/5/2021 (7) out of (7) clients stated that none of their items have gone missing and they would tell staff if their items went missing. On 11/17/2021 (3) out of (5) clients stated none of their items have gone missing and they would tell staff if their items went missing.

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 allegation is UNSUBSTANTIATED.

Exit interview conducted. A copy of this report and Appeal Rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Nina Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2