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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197606428
Report Date: 10/29/2020
Date Signed: 10/29/2020 02:50:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:BRIDGES OF HOPE & LOVE #2FACILITY NUMBER:
197606428
ADMINISTRATOR:MARIA ANGELES TRINIDADFACILITY TYPE:
740
ADDRESS:22604 PAMPLICO DRIVETELEPHONE:
(661) 673-5938
CITY:SAUGUSSTATE: CAZIP CODE:
91350
CAPACITY:6CENSUS: 5DATE:
10/29/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:MARIA ANGELES TRINIDAD/ AdministratorTIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Patrick Shanahan conducted a virtual visit of this facility. At 11am, the LPA toured the facility for health and safety concerns with the assistance of the facility administrator, Maria Trinidad.

During a COVID-19 Welfare phone call, conducted by LPA Elizabeth Arambulo, on 10/28/2020 the administrator confirmed that on 10/18/2020 she conducted an interview with a potential new staff. The administrator stated that she was not sure if this person would be a good fit as a new employee and wanted her husband to conduct a second interview with the potential new staff. The second interview was scheduled for the next day, but the applicant allegedly did not have a place to stay. As such, the administrator offered the applicant the option to stay on a couch in the facility garage. The applicant agreed and stayed the night in the facility garage. The applicant was not finger print cleared or associated to the facility.

The next day, the administrator's husband arrived at the facility and conducted a second interview, where it was determined that the applicant would not be a good fit for the facility. After the applicant left, the applicant allegedly became upset and threatened the administrator and the facility. The administrator decided to go to the police and filed a restraining order against the applicant. This incident was not disclosed to the case carrying LPA, nor was an incident report submitted to the Department.

Based on the above information, the Administrator allowed an uncleared person to stay overnight in the facility garage, and failed to report an unusual incident to the Department.

Deficiencies issued per California Code of Regulations Title 22. Civil penalties assessed. Appeal rights issued. Exit interview conducted. A copy of the report was issued via email for signature.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick ShanahanTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BRIDGES OF HOPE & LOVE #2
FACILITY NUMBER: 197606428
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/29/2020
Section Cited

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87355(e)(1) Criminal Record Clearance: All individuals subject to a criminal record review...(b) shall prior to working, residing or volunteering in a licensed facility. (1)Obtain a California clearance or a criminal record exemption as required by the Department.
This requirement is not met as evidenced by:
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Based on Administrator admission. The licensee did not comply with the above regulation. A caregiver applicant was allowed to sleep at the facility and was not finger print cleared and associated to the facility.
This is an immediate health and safety risk to residents in care.
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Type B
10/29/2020
Section Cited

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80061 Reporting Requirements
(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information…shall be submitted to CCL
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within 7 days following the occurrence of such event. (1)(E) Any unusual incident which threatens the physical or emotional health or safety of any client. This requirement was not met as evidenced by; Based on administrator admission, the Licensee did not assure that a verbal threat was reported to CCL. This poses a potential health and safety risk to 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.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick ShanahanTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2020
LIC809 (FAS) - (06/04)
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