197608043-10-6-2023-31-AS-RRAZ-D9VMTC-20241009095315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608043
Report Date: 10/06/2023
Date Signed: 10/06/2023 10:24:07 AM

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
09/21/2023 and conducted by Evaluator Evelin Rios

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20230921152950

FACILITY NAME:	BOOTS BETTER LIVING		FACILITY NUMBER:	197608043
ADMINISTRATOR:	WILLIE JORDAN		FACILITY TYPE:	735
ADDRESS:	3021 KILDARE STREET		TELEPHONE:	(661) 951-9548
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	6	CENSUS: 6	DATE:	10/06/2023
		UNANNOUNCED	TIME BEGAN:	08:06 AM
MET WITH:	Willie Jordan		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff does not provide adequate food service to residents.
Staff does not provide isolation to sick resident.
Staff does not ensure resident's grooming needs are being met.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Evelin Rios and Lorena Casillas conducted an unannounced subsequent complaint visit to this facility to investigate and deliver determinations for the above allegations. LPA was greeted by administrator Willie Jordan who granted access. LPA explained the reason for the visit.

Allegation #1: Staff does not provide adequate food service to residents.
It is alleged client #1 (C1) cannot have snacks and the home does not provide proper meals throughout the day. To investigate the above allegation, LPA conducted a physical plant tour of the facility's kitchen on 09/28/2023 and again on 10/06/2023. On both days LPA observed a 2-day perishable and 7-day nonperishable supply of food and snacks.. LPA reviewed facility menu which indicated a variety of meals. LPA interview with Administrator revealed due to Covid-19 they are limited as to what they can send with the clients for lunch for their work/day program.
(LIC9099-C continued on next page)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

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-20230921152950

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: BOOTS BETTER LIVING	FACILITY NUMBER: 197608043
	VISIT DATE: 10/06/2023

NARRATIVE

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According to the administrator they send clients with sandwiches for lunch however the client may be allowed to purchase food at their work/day program. Based on interviews, observations and record review, there was insufficient evidence to prove that staff does not provide adequate food service to residents, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation #2: Staff does not provide isolation to sick resident.
It is alleged when client #1 (C1) is feeling ill, the staff do not allow C1 to stay home and do not provide accommodations. To investigate the above allegation, on 09/28/2023 at approximately 4:00 p.m. LPA Rios interviewed C1. Interview with C1 revealed they do not want to stay home even when they feel tired because they would rather be productive outside the house. C1 denied the allegation. LPA Rios interview with administrator on 09/28/2023, the administrator denied the allegation. According to the administrator clients can stay home when they are feeling ill. Based on interviews, there is insufficient evidence to prove that staff does not provide isolation to sick resident, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation #3: Staff does not ensure resident's grooming needs are being met.
It is alleged staff does not provide razors to (C1) when they need to shave. To investigate the above allegation, on 10/06/2023 at approximately 9:35 a.m. LPAs observed different color razors in C1's bathroom. Interview with administrator, revealed C1 is encouraged to self groom and C1 likes to purchase these particular razors themselves. Based on interviews and observation there is insufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

No deficiencies cited, exit interview conducted, copy of report.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC9099 (FAS) - (06/04)

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