197605091-4-28-2023-31-AS-EMIR-CTUN7K-20230718101251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197605091
Report Date: 04/28/2023
Date Signed: 04/28/2023 01:25:29 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/21/2023 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20230421080513

FACILITY NAME:	YONG CARE HOME		FACILITY NUMBER:	197605091
ADMINISTRATOR:	GARY JOHNSON		FACILITY TYPE:	740
ADDRESS:	1539 W. AVENUE L-12		TELEPHONE:	(661) 916-9351
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	6	CENSUS: 1	DATE:	04/28/2023
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Gary Johnson		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Facility staff lock facility gates.

INVESTIGATION FINDINGS:

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On 04/28/2023 LPA Rios arrived the facility mentioned above to conduct a unannounced Complaint Visit at 10:45 a.m. Upon arrival LPA observed two gates. One (1) of two (2) gates was locked with a Padlock requiring a key and the second gate was an electric gate. At 10:45 a.m. LPA called the Licensee's cell phone number and left a voicemail. LPA then called facility number and left a voicemail. At 11:14 a.m. LPA emailed Licensee that LPA was at the facility. Licensee contacted LPA at 11:17 a.m. and informed LPA Co-Licensee Yong was at the facility with one resident. LPA informed Licensee Gary Johnson reason for the visit. Co-Licensee Yong allowed access shortly after.
At 11:31 a.m. LPA Rios and Yong conducted a physical plant tour of the facility. There were no health and safety issues or concerns observed.
Allegation: Facility staff lock facility gates.
It is alleged the locked gate and electric gate prevent visitors from having access to the facility and therefore the gates are obstructing facility passageways.
(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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 31-AS-20230421080513

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: YONG CARE HOME	FACILITY NUMBER: 197605091
	VISIT DATE: 04/28/2023

NARRATIVE

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(LIC9099-C Continued)
To investigate LPA interviewed Yong and Yong revealed a lock was placed on the gate because they've had incidents with intruders coming onto their property when it was just Yong and a resident at the facility. Gary arrived at the facility at approximately 11:50 a.m. and met with LPA. Gary informed LPA they have a Padlock on the gate for security. At 11:53 a.m. LPA called Los Angeles County Fire Department Fire Prevention Division for Lancaster and Palmdale to inquire if the Fire Safety Inspection still stands and if the Padlock and electric gate are fire safety concerns. Representative for the department informed LPA there are no fire safety issues because the electric gate has a remote that will open the gate. The remote allows for "single action access". LPA advised Gary, Licensed Any duly authorized officer, employee or agent of the licensing agency may, upon proper identification and upon stating the purpose of his/her visit, enter and inspect the entire premise of any place providing services at any time, with or without advance notice. Therefore facility must make a better effort to answer the facility phone number or mobile number to allow for quicker access to the facility. Based on interviews conducted and LPA's observation this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Copy of this report provided.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC9099 (FAS) - (06/04)

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