198600002-2-7-2024-28-AS-RORN-D2EUAZ-20240213142534

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600002
Report Date: 12/14/2023
Date Signed: 02/07/2024 03:23:39 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
12/07/2023 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231207135705

FACILITY NAME:	MOUNTAIN VIEW CARE		FACILITY NUMBER:	198600002
ADMINISTRATOR:	CAROLINE TAN		FACILITY TYPE:	735
ADDRESS:	2622 MOUNTAIN VIEW ROAD		TELEPHONE:	(626) 448-1682
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91732
CAPACITY:	83	CENSUS: 77	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Caroline Tan		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff discriminate against the resident

INVESTIGATION FINDINGS:

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The purpose of this amended report is to remove confidential information.
At today's visit Client C 1 was interviewed telephonically at 3:00 PM and LPA delivered and obtained signature for the amended report.
Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Caroline Tan and explained the reason for the visit.
The purpose of the visit is to investigate the above allegation.
At today's visit Staff and Client roster were submitted.Administrator was interviewed at 9:25 AM.
Client's 2-8 were interviewed from 9:45 AM to 10:45 AM.
Staff S 1 and S 2 were interviewed from 10:45 AM to 11:15 AM.
Client C 1 and C 5's file was reviewed and Physician's Report, Appraisal Needs and Services Plan, and Identification and Emergency Information page was submitted.
In regards to the allegation, Facility staff discriminate against the resident based on interviews conducted and information gathered 7 out of 7 client's interviewed stated that the staff do not discriminate against any client's and that staff work very hard and do very 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: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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-20231207135705

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: MOUNTAIN VIEW CARE	FACILITY NUMBER: 198600002
	VISIT DATE: 12/14/2023

NARRATIVE

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6 of 7 client's interviewed stated that they have never observed C 5 harass C 1 and have not seen any wrong doing.
Said there has been nothing inappropriate between the 2. Have seen them talking and it is respectable.
Also stated that C 5 is friendly and will get snacks down the street for them.
C 5 stated there was no wrong doing with C 1. Said he asks how she is doing and jokes around, but she said he was a nag so he backed off.
Spoke with Administrator who stated that there has not been any discrimination. Said that they took action right away when C 1 came to her complaining about C5. C 1 said C 5 was bothering her so right away told C 5 not to bother her.
Also stated that C 1 has had other incidents with 2 other client's saying in one incident the 1 client spoke to her too loud and in the other incident the client said hi and C 1 screamed at the top of her voice to not say hi.
Stated that C 1 is very sensitive.
Staff S 1 and S 2 stated that staff have not discriminated
Stated that C 5 is nice and have not seen him harassing C 1. Said there has been no wrong doing.
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: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

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