197609804-7-25-2024-31-AS-NMAN-D96KFY-20240916075241

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609804
Report Date: 07/25/2024
Date Signed: 07/25/2024 04:06:11 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
06/05/2024 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20240605124830

FACILITY NAME:	ALLIANCE ADULT RESIDENTIAL HOMES INC		FACILITY NUMBER:	197609804
ADMINISTRATOR:	WAKABI, MOSES D		FACILITY TYPE:	735
ADDRESS:	7821 HESPERIA AVENUE		TELEPHONE:	(747) 254-4154
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	4	CENSUS: 4	DATE:	07/25/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Moses Wakabi, Administrator		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Staff is withholding food from a client
Staff is not treating a client fairly while in care
Staff mishandled a client while in care

INVESTIGATION FINDINGS:

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At 1:00 PM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced subsequent complaint visit. LPA met with Moses Wakabi, Administrator, and disclosed the reason for the visit.

An initial visit was conducted on 06/11/2024. During the initial visit at 09:50 AM, LPA requested resident and staff roster. At 10:00 AM, LPA requested copies of pertinent information which include, but not limited to Physician’s Report, Admission Agreement, Appraisal Needs and Services Plan, etc., relevant to the investigation. At approximately 10:10 AM, LPA conducted a physical plant tour. Between 10:20 AM – 01:00 PM, LPA conducted an interview with the Administrator, four (4) Staff, a Witness, and three (3) out of four (4) clients who were available.

Continue on LIC 9099

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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-20240605124830

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ALLIANCE ADULT RESIDENTIAL HOMES INC	FACILITY NUMBER: 197609804
	VISIT DATE: 07/25/2024

NARRATIVE

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Staff is withholding food from a client:

It was alleged that staff did not allow client #1 (C1) to take bananas. To investigate this allegation LPA conducted interviews with Administrator and staff and it was revealed that the facility never withholds any food from clients; however, on 06/03/2024, C1 tried to get a full bunch of bananas. C1 was reminded by staff to leave some bananas for the other clients. LPA was informed that the staff always provides extra food to C1 and never withholds any food/snacks. Furthermore, interviews with two (2) out of three (3) clients confirmed that the facility always provides sufficient food and snacks daily and never withholds food from them. Additionally, during the time of the visit LPA toured the facility and observed enough food and snacks for all clients. Clients were also observed to take and eat any food/snacks they wanted. Based on interviews and LPA’s observation this allegation is deemed Unsubstantiated.

Staff is not treating a client fairly while in care:

It was alleged that the facility staff do not treat C1 the same as other clients in the facility. To investigate this allegation, LPA conducted interviews with Administrator, and staff and it was revealed that C1 gets agitated easily and becomes aggressive to which staff must intervene and verbally redirect C1. Additionally, LPA was informed that during the recent incident on 06/03/2024, C1 caused property damage. Staff intervened to prevent more damage to the property. Moreover, LPA was informed that the staff are well trained to effectively interact and redirect a client in a case as such. Although, C1 might think that the staff is not treating them fairly; interviews with Administrator four (4) staff and two (2) out of three (3) clients confirmed that all clients at this facility are treated with respect and dignity. Based on the interviews this allegation is deemed Unsubstantiated.

Continue on LIC 9099

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20240605124830

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ALLIANCE ADULT RESIDENTIAL HOMES INC	FACILITY NUMBER: 197609804
	VISIT DATE: 07/25/2024

NARRATIVE

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Staff mishandled a client while in care:

It was alleged staff has placed hands on C1 in an aggressive manner. To investigate this allegation, LPA conducted interviews with Administrator, four (4) staff members and two (2) out of three (3) clients. Interview with the Administrator revealed that facility provides training to all staff regarding on how to appropriately handle the clients. Administrator also informed LPA that they never witnessed any staff member handling a client a rough manner. In addition, during the interviews with four (4) out of four (4) staff members LPA was informed that the facility does not handle clients in rough manner and all parties interviewed denied the above allegation. Moreover, two (2) out of three (3) clients confirmed that the facility staff always handles them in a professional manner, and they never witnessed staff handling other clients roughly. Based on the information this allegation is deemed Unsubstantiated.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

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