191640255-3-23-2023-11-AS-MVAO-CQ8TS3-20230324145828

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191640255
Report Date: 01/26/2023
Date Signed: 03/23/2023 12:19:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/02/2022 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20220802085733

FACILITY NAME:	FRANK'S ADULT RESIDENTIAL HOME		FACILITY NUMBER:	191640255
ADMINISTRATOR:	EDWARD GOODSON		FACILITY TYPE:	735
ADDRESS:	1911 W. 137TH STREET		TELEPHONE:	(310) 632-1213
CITY:	COMPTON	STATE: CA	ZIP CODE:	90222
CAPACITY:	16	CENSUS: 15	DATE:	01/26/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Francine Law		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff used a taser on resident
Resident sustained injuries while in care
Staff made inappropriate comments towards resident
Staff are using an inappropriate form of punishment for residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Thursday, January 26, 2023. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with House Manager Francine Law and spoke to Licensee Edward Goodson via telephone. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: During the course of the investigation on 08/11/2022 and 01/26/2023 LPA Bunker interviewed staff 1-2 (S1-S2) and residents 2-6 (R2-R6). LPA Bunker asked questions relevant to the nature of the complaint. LPA Bunker requested and reviewed R1's records. S1-S2 and LPA Bunker toured the facility to observe and identify any signs of neglect, abuse, or other immediate health and safety threats. We did not observe any signs of neglect or abuse during the visits. S1-S2 and R2-R6 all stated staff did not use a taser on resident.
See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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 3

Control Number 11-AS-20220802085733

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FRANK'S ADULT RESIDENTIAL HOME	FACILITY NUMBER: 191640255
	VISIT DATE: 01/26/2023

NARRATIVE

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Continued LIC9099-C page 2

S1-S2 and R2-R6 stated none of the residents sustained any injuries while in care. S1-S2 stated staff is not making inappropriate comments or punishment towards residents. LPA Bunker requested copies of supporting documents.

Allegation #1: Staff used a taser on resident
S1-S2 and R2-R6 all stated staff did not use a taser on any resident.

Allegation #2 Resident sustained injuries while in care
S1-S2 and R2-R6 stated none of the residents sustained any injuries while in care.

Allegation #3 Staff made inappropriate comments toward resident
S1-S2 and R2-R6 stated staff is not making inappropriate comments towards any of the residents.

Allegation #4 Staff are using an inappropriate form of punishment for residents
S1-S2 and R2-R6 stated staff is not using an inappropriate form of punishment on residents.

Investigation revealed the following: Staff 1-2 (S1-S2) and residents 2-6 (R2-R6) were interviewed and stated the above allegations are false. S1-S2 stated R1 got upset with staff 3 (S3) because she told him he will not get a cigarette until he made some improvement. R1-R2 stated S3 didn't ask R1 to make his bed. However, R1 did through his sheets and clothes on the floor. Staff 1-2 (S1-S2) and resident 2-6 (R2-R6) stated R1 hit S3, in the face. S3 never hit or tased R1. S1-S2 and R2-R6 stated R1 was the abuser, he was physically aggressive toward S3 by putting his hands on her. R2-R6 stated R3 is an older woman and did not deserve to be punched in the face by R1. S1-S2 stated S3 called 911, and Compton Sheriff's Department came to the facility. S1 stated he called R1's mother, and R1 also, called his mother to report the incident. S1 stated R1 left the facility and started walking down the street before the police arrived. S1 stated the Sheriff did not leave a police report because R1 walked away, the Sheriff stopped R1 and placed him on 5150 hold. S1-S2 stated S3 went to the hospital for evaluation. S1-S2 and R2-R6 stated S3 did not have a taser and she did not use a taser to control R1's arm. S1-S2 and R2-R6 stated the facility staff does not have tasers at the facility and that the staff does not use tasers on residents.
See continued LIC9099-C page 3C9099-C page 3

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20220802085733

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FRANK'S ADULT RESIDENTIAL HOME	FACILITY NUMBER: 191640255
	VISIT DATE: 01/26/2023

NARRATIVE

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Continued LIC9099-C page 3

S1-S2 stated R1 was not off his medications for eight months. S1-S2 stated R1 refused to take his shots for about three (3) to four (4) months. S1-S2 stated when R1 missed his medications they will contact the physician, R1's conservatory which is his mother, and self-report the incident to Community Care Licensing and all the appropriate agencies. S1-S2 stated R1's mother took R1 to the hospital because he refuses to take his shots. S1-S2 stated R1's mother tried to convince R1 to take his shots and he refuses to do so. S1-S2 stated R1's medical records are documented and that he refuses to take his medication according to his physician's direction. S1-S2 stated R1 did not have any injuries or bruises on his left arm and it was not red. S1-S2 stated nor did R1 have a scrape on his ankle. Licensee Mr. Goodson stated he never told anyone we have people like R1, and we have to use a taser on them is a false statement. S1-S2 stated R1 is no longer residing at the facility. S1-S2 stated S3 is deceased but it had nothing to do with R1 punching S3 in the face causing injuries and bruises to the right side of her face. R2-R6 stated they were happy living at the facility, their care needs are being met, and the staff treats them with dignity and respect. R2-R6 stated they had no problems. S1-S2 and R2-R6 stated they never witnessed staff make inappropriate comments toward residents, nor have they observed or witnessed staff using an inappropriate form of punishment to residents. S1 stated the complainant does handle the facility's financial records and doesn't knows anything about his staff's payroll. S1 stated the facility's financial plan ensures the resources necessary to meet the operating costs for the care and supervision of residents. S1-S2 and R2-R6 all denied the allegations.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. 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 deemed unsubstantiated.

There were no deficiencies cited.

Exit interview conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC9099 (FAS) - (06/04)

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