197803708-8-22-2023-28-AS-TVAO-CW2LQB-20230926085712

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197803708
Report Date: 08/22/2023
Date Signed: 08/22/2023 01:06:20 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
08/15/2023 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230815102036

FACILITY NAME:	BURTREE RESIDENTIAL FACILITY		FACILITY NUMBER:	197803708
ADMINISTRATOR:	LAMAUIG, JOYCELYN		FACILITY TYPE:	735
ADDRESS:	16422 BURTREE STREET		TELEPHONE:	(626) 363-4162
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	6	CENSUS: 6	DATE:	08/22/2023
		UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Joycelyn Lamauig, Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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unlawful eviction.
Facility is not meeting the dietary needs of the client.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Cynthia Chan and Nune Margaryan conducted a complaint investigation regarding allegations listed above. LPAs arrived unannounced and met with Administrator, Joycelyn Lamauig. The purpose of the visit was explained.

LPAs obtained copies of the staff and client rosters, reviewed files, and conducted interviews. Interviews were held with the Administrator, 4 Clients, and a family member. LPA attempted to interview C-1 but was not successful.

The investigation revealed the following:
Regarding allegation – Unlawful eviction. It is alleged Client #1 (C-1) was facing an eviction due to facility wanting more rent and threatening to evict the client. The Administrator stated that an eviction was given to C-1 a year ago. However, C-1 is still residing at the facility and has been paying partial amount of the rent.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

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 28-AS-20230815102036

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BURTREE RESIDENTIAL FACILITY	FACILITY NUMBER: 197803708
	VISIT DATE: 08/22/2023

NARRATIVE

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Administrator denied threatening to evict the client but rather, trying to provide resources to C-1 to assist with fulfilling the rent. LPA interviewed C-1’s family member who indicated that the administrator had provided suggestion on how to obtain more benefits to cover the rent. The family member stated this has not been done due to lack of time. LPAs reviewed the eviction notice that was issued back on 8/1/22 and did not observe any other evictions after that date. Based on the information gathered, the eviction issued was valid at that time. However, since there is no eviction issued at the current time, this allegation is unsubstantiated.

Regarding allegation – Facility is not following the dietary needs of the client. It is alleged that the facility is preparing food with dairy which the client cannot eat. LPAs interviewed the administrator who stated she is aware of C-1’s food allergy and does not provide any food to C-1 with dairy products. She stated the other clients do not have any food allergies. She would prepare separate food due to C-1’s preference and allergy. LPA interviewed 4 Clients who stated they eat 3 meals a day. They do not have food allergies and are served a variety of nutritious foods. C-1’s roommate indicated that C-1 is allergic to dairy products and does not observe staff serving C-1 dairy. There is no sufficient evidence to corroborate this allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with the Administrator. A copy of this report along with the appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

LIC9099 (FAS) - (06/04)

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