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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197803708
Report Date: 08/17/2022
Date Signed: 08/17/2022 03:07:19 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, 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
08/11/2022 and conducted by Evaluator Luis Mora
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220811150320
FACILITY NAME:BURTREE RESIDENTIAL FACILITYFACILITY NUMBER:
197803708
ADMINISTRATOR:LAMAUIG, JOYCELYNFACILITY TYPE:
735
ADDRESS:16422 BURTREE STREETTELEPHONE:
(626) 363-4162
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:6CENSUS: 6DATE:
08/17/2022
UNANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Joycelyn Lumauig – AdministratorTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
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9
Staff are making resident in care overmedicate.
Staff are not providing a safe environment for resident in care.
INVESTIGATION FINDINGS:
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5
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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced complaint visit to determine the validity of the above-mentioned allegations. LPA met with Administrator Joycelyn Lumauig and explained the reason for the visit.

The investigation consisted of the following: LPA obtained a copy of the residents and staff rosters and interviewed the Administrator and Client 1 – Client 6.

The investigation revealed the following: regarding the allegation "staff are making resident in care overmedicate", it is alleged that the administrator is advising C1 to take twice the dosage of medication. Administrator denied the allegation and stated that she follows doctor’s orders. Interview with C1 revealed that C1 was not being told to take double dosage, but C1 believed he was being over-medicated due to getting medication 3 times a day. C1 was not for sure if he was being over-medicated or not.
(CONTINUED TO LIC 9099C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Stefanie Coronel
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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 2
Control Number 28-AS-20220811150320
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: BURTREE RESIDENTIAL FACILITY
FACILITY NUMBER: 197803708
VISIT DATE: 08/17/2022
NARRATIVE
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The other 5 clients denied the allegation and stated that the administrator gives their medication as prescribed.

Regarding the allegation "staff are not providing a safe environment for resident in care", it is alleged that it is not safe in the facility due to physical altercations among the clients. Administrator denied the allegation and stated that it is peaceful among the clients. Clients interviewed revealed that 5 out of the 6 clients denied this allegation and stated there has been no physical fights.

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.

Exit interview held and a copy of the report was provided.
NAME OF LICENSING PROGRAM MANAGER: Stefanie Coronel
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2