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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320023
Report Date: 12/21/2022
Date Signed: 12/21/2022 04:17:18 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/12/2022 and conducted by Evaluator Martessa Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20221212091921
FACILITY NAME:FRIENDS UNITED LLCFACILITY NUMBER:
198320023
ADMINISTRATOR:SUDECK, ELIZABETHFACILITY TYPE:
735
ADDRESS:11725 S TARRON AVETELEPHONE:
(310) 980-0673
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:4CENSUS: 4DATE:
12/21/2022
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Maria E. Collins-House ManagerTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Allegation: Facility staff verbally abused resident while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst’ (LPA) Martessa Brown conducted an unannounced initial 10-day complaint visit to the above facility to investigate the above allegation. LPA conducted Covid-19 Screening and there were no Covid-19 cases. LPA was met by Vianey Ramirez , DSP and was later met by Maria E. Colin, House Manager and the purpose of the visit was explained.

Investigation consisted of the following: On 12/21/22, LPA conducted interviews with staff members #1-#4(S1-S4) and attempted to interview clients #1#-2. LPA requested and resident and staff roster, obtained C1’s Admissions Agreement, IPP, Appraisal/needs and service and staff #1-2 files.

The investigation revealed the following:

Allegation: Facility staff verbally abused resident while in care.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
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 3
Control Number 11-AS-20221212091921
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: FRIENDS UNITED LLC
FACILITY NUMBER: 198320023
VISIT DATE: 12/21/2022
NARRATIVE
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It was alleged that staff could be heard yelling and using inappropriate and foul language to client in care. On 12/21/22, LPA interviewed staff S1-S3 and S4 needed a Spanish translator via translation line, all staff stated S1 was on the phone while S2 was at the facility. During the phone conversation, clients were able to grab important papers from off the desk and drew on them. Staff indicated the adult day program was on the phone with C1 during incident. During interviews with S1 and S2 both stated profanity was used while on the phone but not directed towards client. S1 stated, based on their culture they have used profanity towards clients but it’s like talking to their kids. LPA attempted interviews with C1 and C2 but was limited and C3 and C4 were unable to communicate.

Based on LPA observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Exit Interview Conducted, appeal rights were explained, and a copy of this report was furnished.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20221212091921
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FRIENDS UNITED LLC
FACILITY NUMBER: 198320023
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2022
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights
(1) To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement was not met as evidenced by:
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Licensee will review regulation and come up with a plan on how they will avoid incidents form happening and train staff on personal rights Reg 80072 .

License will submit proof to LPA Brown via email to martess.brown@dss.ca.gov.
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Based on observations and interviews conducted, staff S1-S2 stated was on the phone while at the facility and client had access to important papers and were drawn on. Staff used profanity while careing for clients.
This is a potential risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3