198600241-5-5-2022-28-AS-SCOL-CEYUGE-20220601153409

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600241
Report Date: 05/05/2022
Date Signed: 05/05/2022 04:21:40 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
04/29/2022 and conducted by Evaluator Luis Mora

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220429082117

FACILITY NAME:	CHOICES R US - SPRY		FACILITY NUMBER:	198600241
ADMINISTRATOR:	BRADFORD, SHAJUANA		FACILITY TYPE:	735
ADDRESS:	9614 SPRY ST		TELEPHONE:	(562) 302-0348
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90242
CAPACITY:	6	CENSUS: 6	DATE:	05/05/2022
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Shajuana Bradford – Administrator		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff did not provide appropriate supervision to residents in care
Staff yelled at resident in care
Staff tied a shirt around resident's face
Staff denied visitation to resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced subsequent complaint investigation visit regarding the above allegations. LPA Mora met with Administrator Shajuana Bradford and explained the reason for the visit. LPA Mora conducted the initial complaint visit this morning between 9:00am-11:00am and had to return at 2:30pm due to all clients had already left to their day program in the morning.

The investigation consisted of the following: On 05/05/2022 between 9:00am and 11:00am, LPA Mora obtained copies of client and staff roster, Resident 1 (R1) and Resident 2 (R2) physician report and Individual Program Plan (IPP), interviewed Staff 1 (S1) and Administrator, and tour the facility. On 05/05/2022 between 11:50am and 12:10pm, LPA Mora interviewed Staff 2 (S2) and Staff 3 (S3) via telephone and attempted to contact R1 and R2 regional center service coordinators. On 05/05/2022 between 2:30pm and 4:30pm, LPA interviewed Resident 1 – Resident 6 (R1 – R6) and Staff 4 - Staff 6 (S4 - S6) at the facility.

(CONTINUED TO LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stefanie Coronel	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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-20220429082117

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 - SPRY	FACILITY NUMBER: 198600241
	VISIT DATE: 05/05/2022

NARRATIVE

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The investigation revealed the following: regarding the allegation " staff did not provide appropriate supervision to residents in care", it is alleged that R2 has been beating up R1 and his roommate R3 in the middle of the night, and R1 has communicated this to staff, but nothing has been done. Staff interviewed denied this allegation and stated that no physical violence has occurred between the residents and no resident has told them anything about being beat up. R1 stated that R2 pushed him a very long time ago when he moved in, but was not able to provide details. R1 stated R2 has not hurt him recently. R3 stated he has not been beat up by R2 and has not seen R2 beat up R1. R2 denied ever hurting R1 or R3. The rest of the residents stated they have not seen any resident hurt another resident.

Regarding the allegation "staff yelled at resident in care", it is alleged that the administrator has yelled at R1 and R4. Administrator denied this allegation. Staff interviewed also denied this allegation and stated that neither the administrator nor other staff have yelled at the residents. Residents interviewed revealed that they have not been yelled at by the administrator or staff.

Regarding the allegation "staff tied a shirt around resident's face", it is alleged that the facility ran out of face mask sometime in the summer of 2021 and the Administrator tied a t-shirt on R1’s face and the t-shirt was smashing R1’s nose. Administrator and staff interviewed denied this allegation and stated they always have mask available for the residents. R1 also denied this allegation. Residents interviewed revealed that they are always provided mask and no t-shirt are tied on their face. During the tour conducted today, the LPA observed sufficient mask for all residents.

Regarding the allegation "staff denied visitation to resident in care", it is alleged that staff deny outdoor visitation for R1. Administrator and staff denied this allegation and stated they have no issues with anyone visiting the residents if the visitors wear their mask and allow the facility staff to conduct a Covid-19 symptom screening prior to entering the facility. Administrator also stated that there might be a misunderstanding because she will ask for vaccination information or a Covid-19 negative test which facilities are required to ask per PIN 22-07-ASC and the visitors might perceived this as not being allowed to visit the residents. Residents interviewed revealed that there are no issues with visitation.

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.

SUPERVISOR'S NAME: Stefanie Coronel	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Luis Mora	TELEPHONE: 323-981-3964
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

LIC9099 (FAS) - (06/04)

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