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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320147
Report Date: 09/19/2024
Date Signed: 09/19/2024 02:39:21 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/10/2024 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20240910085830
FACILITY NAME:ICAN CALIFORNIA ABILITIES NETWORK LONG BEACHFACILITY NUMBER:
198320147
ADMINISTRATOR:CLAIRE ROAFACILITY TYPE:
775
ADDRESS:4200E.PACIFIC COAST HWY.STE200TELEPHONE:
(310) 374-8295
CITY:LONG BEACHSTATE: CAZIP CODE:
90804
CAPACITY:18CENSUS: 54DATE:
09/19/2024
UNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Executive Director Scott ElliotTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not provide a safe and comfortable accommodation for a client.
Staff do not have adequate record keeping.
INVESTIGATION FINDINGS:
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On 09/19/24 Licensing program analyst (LPA) Villegas conducted an initial complaint visit regarding the allegation(s) above. LPA met with Executive Director (ED) Scott Elliot as the purpose of today's visit was explained.

The investigation consisted of the following: On 09/19/24 LPA Villegas obtained copies of the staff and client rosters, activity calendar, and a copy of communication regarding outdoor clubs. On 09/19/24 LPA Villegas between 10am-11am LPA conducted interviews with ED and staf #1-4 (S1-S4), between 11:30am- 12:45pm LPA conducted interviews with Clients #1-6 (C1-C6), and conducted a review of 6 client files.

The investigation revealed the following:
Allegation: Staff did not provide a safe and comfortable accommodation for a client.
It is being alleged that a client who should not be in the sun was sent to the beach during a heat wave and was forced to stay there.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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 11-AS-20240910085830
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: ICAN CALIFORNIA ABILITIES NETWORK LONG BEACH
FACILITY NUMBER: 198320147
VISIT DATE: 09/19/2024
NARRATIVE
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On 09/19/24 LPA interviewed ED regarding the allegation above, ED denied the allegation above and reported all health and safety precautions were taken place during beach outing. On 09/19/24 LPA interviewed S1-S4 regarding the allegation above, 4 of 4 staff interviewed denied the allegation above and reported using all materials needed to ensure clients were staying cool and hydrated during beach outing.
On 09/19/24 LPA interviewed C1-C6 regarding the allegation above, 6 of 6 clients interviewed denied the allegation above and reported feeling safe while on beach outing.

Allegation: Staff do not have adequate record keeping.
It is being alleged that paperwork in client files are not up to date.
On 09/19/24 LPA interviewed ED regarding the allegation above, ED denied the allegation above and reported managers are ensuring all required paperwork is obtained and that it is current. On 09/19/24 LPA interviewed S1-S4 regarding the allegation above, 4 of 4 staff interviewed denied the allegation above. On 09/19/24 LPA conducted a review of 6 client files and observed client files to be incompliance with title 22 regulations.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted with Executive Director Scott Elliot, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2