197609327-9-17-2024-31-AS-RORN-D9UVHA-20241008162648

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609327
Report Date: 09/17/2024
Date Signed: 09/17/2024 04:42:31 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
08/28/2024 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20240828100523

FACILITY NAME:	TERNUS ADULT		FACILITY NUMBER:	197609327
ADMINISTRATOR:	TERNUS, TYLER		FACILITY TYPE:	735
ADDRESS:	43513 62ND STREET WEST		TELEPHONE:	(661) 802-4849
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	4	CENSUS: 4	DATE:	09/17/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Tyler Ternus/ Cesar Solis (signed)		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Staff are not competent to meet the needs of clients in care.
Clients are not free from corporal or unusual punishment by Staff
Staff do not provide those services identified in the client's needs and services plan as necessary.
Facility does not provide food that is safe and of the quality and quantity necessary.
The Facility does not meet the medical needs of the clients in care.

INVESTIGATION FINDINGS:

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On 09/17/2024, Licensing Program Analyst (LPA) Evelin Rios conducted a subsequent complaint investigation visit to continue the investigation on the allegation(s) listed above. LPA met with the Licensee, Tyler Ternus. LPA Rios explained the purpose of this visit. An entrance interview was conducted with the Licensee. Licensee could not stay for the duration of the visit. The house manager Cesar Solis was designated to sign todays report.

LPA Rios along with the Licensee toured the facility at 10:40 a.m. LPA did not observe any health or safety issues during the tour. At 11:05 a.m. LPA reviewed staff trainings and obtained copies of the facility's LIC500, staff schedule, client roster, four (4) of four (4) clients' Individual Program Plans (IPPs), Individual Service Plans (ISPs), Physcian's reports, dental visit forms, facility's program description on Medical Emergencies Procedures, and Special Incident Reports (SIRs). From 12:55 p.m. to 3:31 p.m. LPA conducted interviews with five (5) out seven (7) staff and two (2) out of four (4) clients.
(Continued to LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2024

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 3

Control Number 31-AS-20240828100523

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: TERNUS ADULT	FACILITY NUMBER: 197609327
	VISIT DATE: 09/17/2024

NARRATIVE

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LPA was unable to conduct an interview with client #3 (C3) and client #4 (C4) due to the C3 displaying self injurious behavior and C4 refusing to be interviewed.

Allegation #1: Staff are not competent to meet the needs of clients in care. Regarding the allegation, it was reported the Licensee/Administrator, drinks alcohol on the job. To investigate the allegation LPA Melissa Spaeth conducted an initial visit on 09/04/2024 and on that visit toured the physical plant and reported not observing any health or safety issues. During subsequent visit today LPA Rios conduct a physical plant of the facility. The room designated as the office is maintained locked. LPA did not observe any alcohol in the office or anywhere else in the facility. LPA's interview with Licensee and five (5) staff denied the allegation. LPA's interview with client #1(C1) also denied the allegation. LPA's interview with client #2(C2) did not provide any information relating to this allegation. Based on interviews and physical plant tours conducted the allegation is deemed Unsubstantiated.

Allegation #2: Clients are not free from corporal or unusual punishment by Staff. Regarding the allegation, it was reported clients were hit by the Licensee/Administrator. To investigate the allegation LPA interviewed the Licensee, five (5) staff and two (2) out of four (4) clients. Licensee and staff denied the allegation. Staff interviews revealed never witnessing licensee or other staff at the facility hit a client. LPA's interview with (C1) revealed they have only witnessed other clients hit staff and that staff have kept their composure and are professional when these incidents have occurred. C2 denied the allegation. Based interviews conducted the allegation is deemed Unsubstantiated.

Allegation #3: Staff do not provide those services identified in the client's needs and services plan as necessary. Regarding the allegation, it was reported there are instances where services are not provided to clients, or appropriately provided. To investigate this allegation LPA Rios reviewed four of four clients' records. Review of IPP, ISP and physician's report indicate C1 is independent and does not require assistance with activities of daily living (ADL) such as grooming, bathing, and brushing their teeth, LPA's interview with C1 corroborates they do these activities on their own without prompts or reminders from staff. Review of records indicate C2, C3 and C4 are able to do ADL's on there own but need prompts and reminders to do them. Interviews with Licensee and staff deny the allegation. Staff states refusals rarely happen or don't happen at all, with clients eventually completing such activities when prompted or reminded at a later time. LPA also reviewed physicians reports and dental visit forms and documents reveled medical and dental visits are current. (Page 2 of 3)

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20240828100523

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: TERNUS ADULT	FACILITY NUMBER: 197609327
	VISIT DATE: 09/17/2024

NARRATIVE

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IPPs and ISPs revealed C1 is able to go out into the community on there own. Interview with Licensee revealed staff are encouraged to take clients that require supervision on outings to decrease behaviors. Licensee went on to say clients have the choice to stay at the facility or go to different outings because there is enough staff and two vehicles at this facility. Based on interviews and record review conducted the allegation is deemed Unsubstantiated.

Allegation #4: Facility does not provide food that is safe and of the quality and quantity necessary. Regarding the allegation, it was reported the food served to clients is expired. To investigate the allegation LPA Melissa Spaeth conducted an initial visit on 09/04/2024 and on that visit toured the physical plant and reported not observing any health or safety issues. During subsequent visit today LPA Rios conduct a physical plant of the facility. LPA toured the kitchen and viewed the contents in the refrigerator, and two pantries, LPA did not observe any expired food. LPA's interview with Licensee and five (5) staff denied the allegation. LPA's interview with C1 also denied the allegation. LPA's interview with C2 did not provide any information relating to this allegation. Based on interviews and physical plant tours conducted the allegation is deemed Unsubstantiated.

Allegation #5: The Facility does not meet the medical needs of the clients in care. Regarding the allegation, it was reported client(s) medical incidents are not properly handled. To investigate this allegation LPA reviewed facility's SIRs. Review of SIRs revealed an incident from 08/21/2024 where staff were required to provide aid to a client. Review of staff training revealed staff have current first aid and CPR certification. Review of the facility's Medical Emergencies Procedures states, if the person's medical condition does not require calling 9-1-1, staff should apply first aid to stabilize the condition and then transport the individual to an appropriate treatment facility. For life threatening situations staff should call 911. LPA's interview with staff revealed clients have not had a need for immediate medical attention but would be prepared if something would occur. LPA's interview with C1 corroborates 911 has not needed to be called and they are confident staff are well trained to handle any situation. Interviews with Licensee denies the allegation. Based on interviews and record review the allegation is deemed Unsubstantiated.

Exit interview conducted and a copy of the report was provided. (Page 3 of 3)

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC9099 (FAS) - (06/04)

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