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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592637
Report Date: 08/08/2024
Date Signed: 08/08/2024 12:49:29 PM

Substantiated


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
08/02/2024 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240802152535
FACILITY NAME:ADULT BASIC LEARNING ENVIRONMENT, INC.FACILITY NUMBER:
191592637
ADMINISTRATOR:MIRIAM CUEVASFACILITY TYPE:
775
ADDRESS:452 W. BADILLO ST.TELEPHONE:
(626) 858-5267
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY:30CENSUS: 15DATE:
08/08/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Laura BradshawTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility staff did not transport client in a safe manner.
Staff did not ensure that the client's safety harness was properly secured to the wheelchair during transportation, which resulted in a rash around the client's neck
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Staff S1 and explained the reason for the visit. Shortly thereafter the Administrator arrived.
The purpose of the visit is to investigate the above allegations.
At today's visit the following occurred:
Client and Staff Roster was submitted.
Interview was conducted with the Administrator and Staff S1- S4.
Interview was conducted with Client C1- C4.
LPA reviewed Client C1's file and facility submitted ISP, Physician's Report and IPP.
Facility also submitted client and staff roster, and bathroom log.
In regards to the allegation Facility staff did not transport client in a safe manner, based on interviews conducted and information gathered Staff stated that they were told to send Client C1 home without a harness because of him arriving to program with his hands strapped and hands turning purple when arriving.
Staff and Administrator stated that C1 had been put on transportation bus with his harness many times
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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 5
Control Number 28-AS-20240802152535
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: ADULT BASIC LEARNING ENVIRONMENT, INC.
FACILITY NUMBER: 191592637
VISIT DATE: 08/08/2024
NARRATIVE
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previously.
Staff interviewed were aware that Client C1 had arrived home with his harness loose and having gotten a rash on his neck.
Interview with Regional Center Representative who stated that Thursday August 1, 2024 there was no harness and Friday August 2 it was not put on properly for Client C1.
Also stated that Client C1 was using harness for months. It had been put on previously routinely and properly.
Attempts were made to interview Client C1 and C4 who were both limited in their responses.
Clients C2 and C3 stated that staff are doing a good job assisting with their needs.
Based on LPA’s interviews conducted with staff and clients and LPA's observation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 1), are being cited on the attached LIC 9099D.

In regards to the allegation Staff did not ensure that the client's safety harness was properly secured to the wheelchair during transportation, which resulted in a rash around the client's neck, based on interviews conducted and information gathered it was revealed by the Regional Center Representative that Client C1 was using harness for months. It had been put on previously routinely and properly.
Staff interviewed were aware that Client C1 had arrived home with his harness loose and having gotten a rash on his neck.
Administrator interviewed stated it was possible that Client C1 arrived home with a rash after his harness had been loose.
Attempts were made to interview Client C1 and C4 who were both limited in their responses.
Clients C2 and C3 stated that staff are doing a good job assisting with their needs
Based on LPA’s interviews conducted with staff and clients and LPA's observation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 1), are being cited on the attached LIC 9099D.



NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
08/02/2024 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240802152535

FACILITY NAME:ADULT BASIC LEARNING ENVIRONMENT, INC.FACILITY NUMBER:
191592637
ADMINISTRATOR:MIRIAM CUEVASFACILITY TYPE:
775
ADDRESS:452 W. BADILLO ST.TELEPHONE:
(626) 858-5267
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY:30CENSUS: 15DATE:
08/08/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator Laura BradshawTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not ensure that the client was sent home free of urine and feces
INVESTIGATION FINDINGS:
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In regards to the allegation Staff did not ensure that the client was sent home free of urine and feces based on interviews conducted and information gathered it was revealed in interview with Regional Center Representative who stated that family member of Client C1 said it might be duration of trip 1 hour each way and he could not hold it. Usually urine, but this time feces. Family member said could be because he was scared. Program does take him before transportation, but it might happen anyway.
Interview with staff who all stated that clients are taken to the restroom 30 minutes before they leave for transportation.
Staff said Client C1 had used the restroom right before transportation and was not soiled and his clothes were clean.
ISP dated 07/11/24 states formal objective of having C1 walk to the restroom twice a day with co-active assistance.
Review of Bathroom Log shows Client C1 on August 2, 2024 using the restroom at 11:00 AM and 1:00 PM.
Interview with Client's 2 and 3 who stated they do use the restroom and staff will help assist if needed.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 28-AS-20240802152535
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: ADULT BASIC LEARNING ENVIRONMENT, INC.
FACILITY NUMBER: 191592637
VISIT DATE: 08/08/2024
NARRATIVE
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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 allegation is UNSUBSTANTIATED.
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NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20240802152535
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: ADULT BASIC LEARNING ENVIRONMENT, INC.
FACILITY NUMBER: 191592637
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2024
Section Cited
CCR
82072(a)(2)
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Personal Rights
Each client shall have personal rights which include, but are not limited to, the following:
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Facility to conduct training on how to correctly position Client C1 in wheelchair for transporting and submit signed log of those who attended by POC due date.
Facility submitted signed log at today's visit which was completed on 08/07/24.
Deficiency cleared.
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This requirement is not met with facility failing to have Client C1 to be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs with harness not being on C1 on 8/01/24 and harness being on loosely 08/01/02 which caused an Immediate Health and Safety concern for clients in care.
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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: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5