197603739-2-8-2024-28-AS-RORN-D2NR9S-20240221115002

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603739
Report Date: 02/08/2024
Date Signed: 02/08/2024 04:10:22 PM

Unsubstantiated

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
02/07/2024 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240207140143

FACILITY NAME:	MENTONE HOUSE		FACILITY NUMBER:	197603739
ADMINISTRATOR:	ROBIN PHILLIPS		FACILITY TYPE:	735
ADDRESS:	1980 MENTONE		TELEPHONE:	(626) 398-5629
CITY:	PASADENA	STATE: CA	ZIP CODE:	91103
CAPACITY:	6	CENSUS: 4	DATE:	02/08/2024
		UNANNOUNCED	TIME BEGAN:	12:23 PM
MET WITH:	Maggie Estrada - Administrator		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff sexually abused client.
Staff yelled at client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced visit to investigate the above allegations. There was no one at the facility upon arrival at 12:23pm, Administrator Maggie Estrada arrived to assist with the visit at 12:48, the purpose of today’s visit was explained.

The investigation consisted of the following:
During today's visit, LPA obtained a copy of the Staff/Resident rosters, Copies of Resident #1's (R1) Face Sheet, Physician's Report, Needs and Service Plan, Copies of Regional Center Semi-Annual Behavior Assessment dated December 20, 2023, and Special Incident Reports. LPA reviewed S1's personnel file and obtained copies of trainings. LPA interviewed Administrator and conducted 3 other staff interviews during visit.

(Continued on 9099-C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20240207140143

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: MENTONE HOUSE	FACILITY NUMBER: 197603739
	VISIT DATE: 02/08/2024

NARRATIVE

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The investigation revealed the following:
Allegations: Staff sexually abused client. Staff yelled at client.
It is alleged that S1 sexually abused C1 by touching C1 in their private area, and that S1 yelled at C1 at some point in the month of November 2023. LPA interviewed S1 and S1 stated that they worked at facility only for a few days as coverage during the month of November 2023 and were there for no more than 2-3 hours on the days they covered, S1 stated they only did minor housekeeping and preparing meals during the shift and that S3 was the staff that assisted clients with their Activities of Daily Living (ADL), such as showers, dressing and toileting. S1 stated that they recall having a small conversation with C1 as they observed C1 exit their room and C1 was noticed to have soiled pants, S1 asked for C1 to let staff know when they are soiled so staff can assist, C1 did not respond, S1 stated they never raised their voice, yelled or touched C1 during the days they worked at facility. LPA interviewed 3 other staff and all denied the above allegations and stated they have never nor have they ever seen another staff raise their voice, yell, hit, or abuse clients in any way. Staff stated that they have never observed S1 sexually abuse or yell at C1 and that S1 worked at facility for a short period during the month of November 2023 as coverage, S1 is employed at a sister facility but is sometimes used to cover other facilities. S3 stated that S1 was only there for a few days during the month of November 2023 and did not assist clients with ADL's during those days, S3 further stated that they did not see S1 touch C1 or hear S1 yell at C1 or any other client. Administrator stated that Regional Center conducted an investigation regarding the same allegations and C1 had recanted their allegations as C1 did when administrator questioned C1 of the allegations. Regional Center investigated the allegation of sexual abuse, however, C1 recanted the allegation. LPA attempted to interview 2 clients, however, clients were unable to answer yes or no questions, due to cognitive impairment. C1 was not able to be interviewed as C1 has since passed away at the hospital. LPA toured C1's room there were no concerns, obstructions, or anything out of the ordinary observed.

Based on statements and interviews conducted with staff, clients, review of client files and facility personnel records, there was not enough supportive evidence to concur with the reported allegations.

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

An exit interview was conducted and a copy of this report was provided to Administrator Maggie Estrada.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

LIC9099 (FAS) - (06/04)

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