198600085-1-19-2024-28-AS-DSIS-D7HPA2-20240725110753

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600085
Report Date: 01/19/2024
Date Signed: 01/19/2024 03:17:10 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
11/27/2023 and conducted by Evaluator Ashley Calderon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231127135228

FACILITY NAME:	CHOICES R US - WOODHUE		FACILITY NUMBER:	198600085
ADMINISTRATOR:	BRADFORD, SHAJUANA		FACILITY TYPE:	735
ADDRESS:	9523 WOODHUE ST		TELEPHONE:	(562) 942-1419
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	6	CENSUS: 4	DATE:	01/19/2024
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Assistant Administrator- Rachel Gama		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff sleep while on shift.
Clients are provided ripped bath towels.
Staff did not prevent client from leaving the facility unassisted.
Staff did not ensure hot water temperature was properly maintained.
Facility is malodorous.
Staff falsified emergency drill documents.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Ashley Calderon, conducted a subsequent visit for the above allegations. Upon visit met with DSP Staff Hernando Aragon. LPA Calderon called Facility Assistant Administrator Rachel Gama to assist with visit. Rachel arrived at approximately 9:30 A.M. to assist with this visit.

Initial visit was conducted on 12/7/23, LPA Calderon received email copies of Staff/ Client roster, Client #1-Client #4 (C1-C4) Behavior Plan and C1, C2 and C3 1:1 Proof of Service, Staff In-Service training for medication (1 hour), DSP Training for staff who distribute medication, Medication Administration Records for September 2023, Time sheet for September 2023 and November 2023 and water temperature log for months September and October 2023. LPA toured the facility, (3) bedrooms and (2) bathrooms and facility van. LPA measured hot water in kitchen, (2) bathrooms and water delivered within Title 22 regulations.LPA interviewed Assistant Administrator, Staff #2 (S2) and Client #1 - Client #2 (C1-C2). Client #3 and #4 (C3 and C4) were away at day program. LPA attempt to interview East Los Angeles Regional Center Service Coordinator. (CONTINUATION 9099-C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

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 4

Control Number 28-AS-20231127135228

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: CHOICES R US - WOODHUE	FACILITY NUMBER: 198600085
	VISIT DATE: 01/19/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On today's visit date 1/19/24, LPA Calderon via email was sent Fire drill documentation for 9/2/23 and for 10/02/23. LPA interview Service Coordinator from East Los Angeles Regional Center, interviewed Staff #1 and Staff #3 (S1 and S3), attempt to interview Staff #4 and Staff #5 (S4 and S5).LPA reviewed Special Incident report relevant to an allegation and reviewed water temperature log. LPA observed clients bath towels.

Based on allegation: Staff sleep while on shift. Investigation revealed during LPA interviews with staff Assistant Administrator, S1 and S3 informed LPA they are haven't witness staff sleeping. Client's interviews with C1 and C2, client's could not corroborate with the above allegation, client's are unable to communicate due to cognitive impairments. During LPA's visit dates 12/7/23 and 1/19/24 LPA did not observe staff sleeping on shift.

Based on allegation: Clients are provided ripped bath towels. Investigation revealed during LPA interviews with staff Assistant Administrator, S1, S2 and S3 informed LPA that towels may have become worn and ripped, but there are still sufficient towels and new towels that are bought or replaced, and clients have sufficient towels to permit change. Clients C1 and C2 are unable to client's could not corroborate with the above allegation, client's are unable to communicate due to cognitive impairments. Interview with Service Coordinator at East Los Angeles Regional Center informed LPA that they are not aware clients being provided ripped bath towels. During LPA visits on 12/7/23 and 1/19/24 LPA did not observe any ripped bath towels. LPA did observe ripped towels that are used as rags separate from bath towels for client's.

Based on allegation: Staff did not prevent client from leaving the facility unassisted. Investigation revealed during interviews with Assistant Administrator, S1, S2 and S3 that staff prevent residents from leaving unassisted and deny the above allegation. Clients C1 and C2 are unable to client's could not corroborate with the above allegation, client's are unable to communicate due to cognitive impairments. Interview with Service Coordinator at East Los Angeles Regional Center informed LPA they deny the above allegation and staff assist clients when clients leave facility. LPA reviewed Special Incident report for clients leaving unassisted / absent of clients without leave (AWOL), AWOL incidents reported for 10-17-23 and incident 11-10-23 with clients, reports reviewed by LPA state staff for both AWOL incidents drove to find client's and staff notify sheriff's police department to report missing persons / clients.

(CONTINUATION 9099-C)

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 28-AS-20231127135228

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: CHOICES R US - WOODHUE	FACILITY NUMBER: 198600085
	VISIT DATE: 01/19/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on allegation: Staff did not ensure hot water temperature was properly maintained. Investigation revealed during interviews with Assistant Administrator, S1, S2 and S3 they deny the above allegation and that there has no incidents with hot water not being maintained, staff are not aware of any clients being poured hot water. Interviews with staff, S1 and S3 informed LPA that hot water measurements are conducted to measure hot water temperature. Clients C1 and C2 are unable to client's could not corroborate with the above allegation, client's are unable to communicate due to cognitive impairments. Interview with Service Coordinator at East Los Angeles Regional Center informed LPA that they are not aware of any issues/incidents that have occurred with the above allegation. LPA reviewed log sheet for water temperature facility had in place for dates: June-November 2023, facility logged water temperature measuring between 105-110F, which is within regulations. LPA on visit date 12/7/23 tested hot water and water measured between the required Title 22 Regulations., 105-120F.

Based on allegation: Facility is malodorous. Investigation revealed during interviews with Assistant Administrator, S1, S2 and S3, staff(s) deny the above allegation and that they have not smelled the facility smelling malodorous and no smells of weed coming from the van, facility or staff. Clients C1 and C2 are unable to client's could not corroborate with the above allegation, client's are unable to communicate due to cognitive impairments. Interview with Service Coordinator at East Los Angeles Regional Center informed LPA they do regular visits at the above facility and denied the above allegation and informed LPA they have not smelled the facility smelling malodorous.

Based on allegation: Staff falsified emergency drill documents. Investigation revealed during interviews with S1 denying the above allegation. Assistant Administrator informed LPA that for fire drill conducted on 9/2/23, they were not working at the above facility but informed LPA they conduct fire drills with clients and staff. S2 and S3 informed LPA being unaware if emergency drill documentation's have been falsified by staff, S2 and S3 did inform LPA that facility does conduct fire / emergency/ earthquake drills. Clients C1 and C2 are unable to client's could not corroborate with the above allegation, client's are unable to communicate due to cognitive impairments. Interview with Service Coordinator at East Los Angeles Regional Center informed LPA they are unaware of the above allegation. LPA reviewed fire and earthquake drills for 9/2/23 and 10/2/23 and LPA observed documentation's being present at the facility for review.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations is unsubstantiated. A copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4