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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606347
Report Date: 05/09/2024
Date Signed: 05/09/2024 03:20:11 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
05/01/2024 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240501155416
FACILITY NAME:COGSWELL GARDEN HOMEFACILITY NUMBER:
197606347
ADMINISTRATOR:LILIAN C. SALMORINFACILITY TYPE:
740
ADDRESS:5405 N. COGSWELL ROADTELEPHONE:
(626) 444-3523
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY:15CENSUS: 8DATE:
05/09/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lillian SalmorinTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff does not ensure facility water heater is in good repair
Staff does not ensure facility has hot water for clients in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Glenn Trueman, made a visit to Cogswell Garden Home. The purpose of today's visit is to investigate the allegations above.
On today's visit LPA met with and interviewed Staff S1 and Staff S2 from 1:20 PM to 145 PM
At today's visit staff and resident roster was submitted.
Interview was conducted telephonically with Administrator Lillian Salmorin at 1:50 PM.
Interview was conducted with Client C1- C4 from 1:55 PM to 2:45 PM.
In regards to the allegation Staff does not ensure facility water heater is in good repair, based on interviews conducted and information gathered it was revealed in interviews with staff that a new water heater was installed after 1 day of no hot water. New heater was installed within 24 hours.
Interviews with Clients C1- C4 who all stated that there was new heater installed within 1 day.
Interview with Regional Center Representative who stated that the water heater was replaced within 24 hours.
It should be noted that the San Gabriel Pomona Regional Center's result of their investigation was Unsubstantiated.
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: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
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 2
Control Number 28-AS-20240501155416
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: COGSWELL GARDEN HOME
FACILITY NUMBER: 197606347
VISIT DATE: 05/09/2024
NARRATIVE
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Interview was conducted with the Administrator Lillian Salmorin who stated that the new maintenance man said the water heater was no longer repairable. Stated she gave approval for him to purchase a new one and that he installed it within 24 hours.
LPA observed the new water heater which had a piece of masking tape and on it stating 05/01/2024 replaced.
Documentation from San Gabriel Pomona Regional Center states that Client C1 informed the Service Coordinator that they were offered another shower that has a different heater, but refused.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove
alleged violation did or did not occur, therefore the above allegation is Unsubstantiated.
In regards to the allegation, Staff does not ensure facility has hot water for clients in care, based on interviews conducted and information gathered it was revealed by Regional Center Representative who stated that facility was without hot water for 1 day and Client C1 was offered to shower with hot water in another shower, but refused.
Interview with Staff who stated that there was no hot water for 1 day and the water heater was replaced within 24 hours.
At today's visit hot water temperature measured at 105F. in 2 shower rooms.
Interview conducted with Client C2 - C4 who stated that there was no hot water for 1 day and within a day the new water heater was installed.
It should be noted that the San Gabriel Pomona Regional Center's result of their investigation was Unsubstantiated.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove
alleged violation did or did not occur, therefore the above allegation is Unsubstantiated.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2