197606973-9-7-2024-31-AS-EMIR-DAYVGV-20241113152610

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606973
Report Date: 09/07/2024
Date Signed: 09/07/2024 03:51:41 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, 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
05/02/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240502131856

FACILITY NAME:	FEMMS RESIDENTIAL HOMES I		FACILITY NUMBER:	197606973
ADMINISTRATOR:	FRUCTUOSA M. MORALES		FACILITY TYPE:	740
ADDRESS:	11811 PASO ROBLES STREET		TELEPHONE:	(818) 217-4081
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 6	DATE:	09/07/2024
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Eduardo Morales		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Resident in care sustained multiple unexplained injuries while in care
Staff hit resident in care
Staff did not seek timely medical help for resident in care
Staff stole resident's personal belongings
Staff spoke inappropriately to resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent visit to the facility to conclude the investigation regarding the above allegations. The initial visit was made by LPA Cava on 05/06/24. LPA met with staf Eduardo Morales, and advised them of the complaint. LPA’s investigation consisted of interviews with residents and staff, record review, and a physical plant inspection to insure the health and safety of the residents in care.

Resident in care sustained multiple unexplained injuries while in care/Staff hit resident in care:
In regards to the allegation, it was reported that Resident 1 (R1) has scratches to the knee and bruises under the eye. The reporting party is not sure if these wounds were due to a fall, or abuse by facility staff, as it was also reported that staff slapped R1 in the face. Furthermore, the reporting party stated R1 was alleging that these injuries occurred while they were living at a board and care called Alverado Care Home, located off of Alverado Street, in Los Angeles. No witnesses were identified to this allegation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2024

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 31-AS-20240502131856

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: FEMMS RESIDENTIAL HOMES I	FACILITY NUMBER: 197606973
	VISIT DATE: 09/07/2024

NARRATIVE

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Moreover, no staff name was given or identified to these allegations.

Interview made with the administrator reveal that R1 lost their balance and fell when coming out of the hallway bathroom at approximately 08:10am on 05/01/24. Staff 1 (S1) was present, and they stated they were waiting for R1 outside of the bathroom so that they can assist R1 when R1 gets done. As R1 was exiting the bathroom, R1 just lost their balance and fell. Paramedics were called immediately, and R1 was taken to the hospital to treat R1’s injury to their hip. An Incident Report (IR) was submitted, and Licensing notified. R1 was currently at the hospital at the time of the investigation. They will be discharged to a Skilled Nursing Facility (SNF) for rehabilitation for the hip at discharge.

Interviews with five (5) of five residents made. All five could not corroborate with the allegations made. Based on the information obtained, there was insufficient evidence to prove that R1 sustained multiple injuries while in care, or staff hit R1. Therefore, the allegations are deemed Unsubstantiated at this time.

Staff did not seek timely medical help for resident in care/Staff spoke inappropriately to resident in care:
In regards to the allegation, it was reported that R1 had a fall in the morning of, on or around 05/02/24, and was left unnoticed by staff. R1 was unable to get up. When R1 called for help, staff was verbally abusive towards R1, insisting that R1 could get up on their own. Eventually emergency services were contacted and paramedics came to take R1 to the hospital. No witnesses or staff name given or identified to these allegations.

Interview made with the administrator acknowledged that R1 lost their balance and fell when coming out of the hallway bathroom at approximately 08:10am on 05/01/24. (S1) was present, and they stated they were waiting for R1 outside of the bathroom so that they can assist R1 when R1 gets done. As R1 was exiting the bathroom, R1 lost their balance and fell. S1 deny the allegation of not seeking timely medical attention as paramedics were called immediately, and R1 was taken to the hospital to treat R1’s injury. An Incident Report (IR) was submitted on 05/02/24, and Licensing notified. R1 was currently at the hospital at the time of the investigation. They will be discharged to a Skilled Nursing Facility (SNF) for rehabilitation for the hip at discharge.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2024

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20240502131856

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: FEMMS RESIDENTIAL HOMES I	FACILITY NUMBER: 197606973
	VISIT DATE: 09/07/2024

NARRATIVE

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Interviews with five of five residents were made. All five have no complaints regarding staff services, as staff is able to meet their needs. Moreover, all five residents stated the administrator and staff are never verbally abusive towards them or their peers. Based on the information obtained, there was insufficient evidence to prove that staff did not seek timely medical help for R1, or that staff spoke inappropriately to R1. Therefore, the allegations are deemed Unsubstantiated at this time.

Staff stole resident's personal belongings:
In regards to the allegation, it was reported that R1 is financially abused by a facility staff. It was also reported that staff has been stealing their clothes. Staff name was not given or identified. According to the reporting party, R1 was alleging this occurred while they were living at a board and care called Alverado Care Home, located off of Alverado Street, in Los Angeles.

Interviews made with the administrator and staff deny the allegation, stating R1 has never reported anything missing to them. R1 completed the LIC 621 (Client/Resident Personal Property and Valuables) and everything in R1’s room is accounted for. Moreover, the administrator stated they do not handle resident cash resources.

Interviews with five of five residents also deny the allegation. All five residents stated they have never had to report anything missing or stolen during their stay in the facility.

Based on the information obtained, there was insufficient evidence to corroborate the allegation that staff stole R1 belongings. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2024

LIC9099 (FAS) - (06/04)

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