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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197800744
Report Date: 05/25/2023
Date Signed: 05/25/2023 03:17:12 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, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/04/2023 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230504093545
FACILITY NAME:CASITAS ESPERANZAFACILITY NUMBER:
197800744
ADMINISTRATOR:JOSE GOMEZFACILITY TYPE:
772
ADDRESS:11925 1/4,1/2 11931 ELLIOTT AVTELEPHONE:
(626) 350-5304
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY:13CENSUS: 12DATE:
05/25/2023
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Shannon SteibTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not provide timely medical and dental services to the clients while in care
Staff are not readily available during emergency situations involving a client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Shannon Steib and explained the reason for the visit.
The purpose of the visit is to deliver the findings from the original complaint dated 05/04/2023.
Initial visit was conducted on 05/11/2023 and the following was done:
At 10:05 AM Administrator Shannon Steib was interviewed.
Client's 1-6 were interviewed from 10:20 AM to 11:20 AM.
At 11:20 AM Staff S 1 was interviewed.
Resident and Staff Rosters were submitted.
Client 1's file was reviewed and various documents were submitted.
At todays visit Public Guardian for Client C 1 was interviewed at 2:00 PM telephonically.
In regards to Staff did not provide timely medical and dental services to the clients while in care, based on interviews with clients, staff, Public Guardian and review of documentation it was revealed that Client C 1 stated that staff has taken him to all his doctor appointments. Said follow up appointments have gone well.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
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 28-AS-20230504093545
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: CASITAS ESPERANZA
FACILITY NUMBER: 197800744
VISIT DATE: 05/25/2023
NARRATIVE
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Stated that staff has also taken him to urgent care a couple of times when needed and they took care of it properly. Stated they took him right away. Said staff took him to the dentist a couple of weeks ago.
Stated that staff do an A plus job taking care of medical and emergency situations.
All 6 clients interviewed stated that the facility provides they services they need. Stated they have seen psych doctors on computer and doctor and dental visits nearby.
Staff interviewed stated that Client C 1 has been attending his appointments that they make for him.
Also stated that there was an agreement with C 1's Public Guardian that anything related to medical care would go thru the public guardian first.
Interview with Public Guardian who confirmed that anything related to medical care for C1 would go thru the Public Guardian first. Said this has been happening for 2 to 3 months.
Documentation for C 1 revealed e-mail communication between the facility and Public Guardian regarding C 1's medical needs in a timely manner.
Review of documentation revealed appointments attended 01/29/23 ER, 02/03/23 ER follow up, 02/21/23 ultrasound, 02/23/23 dental, 02/24/23 physical, 03/07/23 labs, 03/13/23 eye exam, 03/21/23 hematology and oncology.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
In regards to Staff are not readily available during emergency situations involving a client , based on interviews with clients, staff, Public Guardian and review of documentation it was revealed that Client C 1 stated that staff has taken him to all his doctor appointments including emergency urgent care situations.
All client's interviewed stated staff do a great job and provide all medical services needed including any emergency care.
Staff stated that C 1 has been taken to all medical appointments including urgent care, primary care doctor, eye and dental and visits to a specialist.
Review of documentation revealed appointments attended 01/29/23 ER, 02/03/23 ER follow up 02/21/23 ultrasound, 02/23/23 dental, 02/24/23 physical, 03/07/23 labs, 03/13/23 eye exam, 03/21/23 hematology and oncology.
Interview with Public Guardian who stated that she has worked closely with the Administrator who will let her know about appointments in advance and also follow up.
Interview with Public Guardian who stated that anything related to medical care for C1 would go thru the Public Guardian first.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20230504093545
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: CASITAS ESPERANZA
FACILITY NUMBER: 197800744
VISIT DATE: 05/25/2023
NARRATIVE
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Public Guardian also stated that any issues at nite regarding Client C 1 that his parent considered an emergency the parent would call the OD line at Public Guardian after hours and there was no answer and then would be upset C 1 was not being taken care of. Parents were unaware of another after hours call line to be reached.
Stated that these emergency related issues at nite were to be communicated thru Public Guardian and it was not handled by the facility with the agreement that medical issues would go thru Public Guardian first.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3