197609337-8-30-2022-31-AS-RRAZ-CJ3VD2-20220908161959

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609337
Report Date: 08/30/2022
Date Signed: 08/30/2022 12:18:19 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
08/13/2021 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20210813100842

FACILITY NAME:	MOLOCK RESIDENTIAL II		FACILITY NUMBER:	197609337
ADMINISTRATOR:	MOLOCK, JONATHAN		FACILITY TYPE:	735
ADDRESS:	43140 E 33RD STREET		TELEPHONE:	(661) 674-8592
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	4	CENSUS: 3	DATE:	08/30/2022
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Brenda Williams		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Facility staff direct the residents to leave the facility during a set time frame
Residents not accorded dignity in relationship with staff
Facility staff speaks inappropriately about residents
Facility staff threatened a resident
Facility staff do not provide a variety of meals
Facility staff does not safe guard residents private information

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent visit to finish investigation into the allegations above. LPA met with facility staff and explained the reason for this visit. LPA spoke with the administrator by telephone and explained the reason for this visit.

Facility staff direct the residents to leave the facility during a set time frame
It is alleged that facility staff make clients leave the facility between 7:30am-3pm Monday through Friday. This allegation was made on 8/13/21. This allegation was also made by the same complainant on 12/01/2021 during another complaint investigation (31-AS-20211201093156). During that investigation interviews were conducted with clients and staff. The allegation was Unsubstantiated based on interviews conducted. Due to that investigation having the same allegation and the same complainant and being investigated after this complaint allegation was made the findings will remain the same. Based on information obtained from previous interviews conducted on 1/11/2022 this allegation is deemed Unsubstantiated also.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Wendell Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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-20210813100842

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: MOLOCK RESIDENTIAL II	FACILITY NUMBER: 197609337
	VISIT DATE: 08/30/2022

NARRATIVE

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Allegations: (2)Residents not accorded dignity in relationship with staff, (3)Facility staff speaks inappropriately about residents, and (4)Facility staff threatened a resident

Regarding the three allegations above it is alleged that clients are spoken to disrespectfully and staff will barge into client rooms, and would threaten clients if they don't do what they are supposed to do. These complaint allegations were also investigated in two separate investigations (Complaint control number 31-AS-20211201093156 & 31-AS-20211230143629). These complaints were submitted by the same complainant as this complaint but were after this complaint came in. During the investigation interviews were conducted with clients and staff regarding the allegations on the dates of 12/13/21 and 1/11/22. Information from interviews with clients and staff reveal that all three allegations were Unsubstantiated. Based on the interviews done on 12/13/21 and 1/11/22 which was after the date that this complaint came on 8/13/21 these three allegations are Unsubstantiated at this time.

Facility staff do not provide a variety of meals
It is alleged that the facility does not provide a variety of meals. During the visit LPA checked the food supply from 11:10-11:15 am and observed there to be a sufficient amount of perishable and non perishable food. LPA also observed a different varieties of food. LPA also looked at the facility menu and observed different items offered to clients. Interviews were previously conducted with staff and clients. Based on the information obtained through observation and interviews this allegation is deemed Unsubstantiated at this time.

Facility staff does not safe guard residents private information
It is alleged that facility staff told client #1 (C1) private information to another client. LPA conducted an interview with facility staff and the administrator regarding this allegation from 10-10:15am. C1 does not reside in this facility anymore as of April 2022. LPA previously spoke with C1 who stated they did not know if this happened. Based on the information obtained this allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Wendell Smith
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

LIC9099 (FAS) - (06/04)

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