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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600271
Report Date: 10/13/2021
Date Signed: 10/13/2021 01:52:44 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
03/12/2020 and conducted by Evaluator Kruz Long
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20200312160422
FACILITY NAME:HAMILTON VILLAFACILITY NUMBER:
198600271
ADMINISTRATOR:ADELA SANTOSFACILITY TYPE:
735
ADDRESS:948 SOUTH HAMILTON BLVD.TELEPHONE:
(909) 620-1933
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:84CENSUS: 51DATE:
10/13/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Adela Santos (Administrator)TIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
Resident was sexually abused while in care.
Resident was physically abused while in care.
Resident was emotionally abused while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kruz Long conducted an unannounced subsequent complaint visit at the facility. Upon arrival, LPA met with Adela Santos (Administrator) and explained the purpose of the visit.

During the initial visit on 03/16/20, LPA obtained a copy of the Staff/Client Roster, conducted a Health & Safety check and toured the physical plant with Adela Santos. LPA observed the physical plant to be in good repair. There is supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days, there is running water, electricity and sufficient Staff. LPA did not observe any immediate Health & Safety risks.

During today's visit, LPA obtained a copy of the Staff and Client roster. LPA interviewed Staff #1 through #7 in the office between 9:55 am to 11:00 am and interviewed Client #1 through #9 in various locations of the facility between 12:00 pm to 12:45 pm. Continue to LIC9099C.......
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kruz Long
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
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 28-AS-20200312160422
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: HAMILTON VILLA
FACILITY NUMBER: 198600271
VISIT DATE: 10/13/2021
NARRATIVE
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In regards to the allegations:
1) Resident was sexually abused while in care.
2) Resident was physically abused while in care.
3) Resident was emotionally abused while in care.

LPA interviewed 7 of 7 Staff who indicated they have never sexually, physically or emotionally abused a Client nor have they heard or witnessed other Staff members sexually, physically or emotionally abused a Client. Interviews with 9 of 9 Clients also indicate that they have never been sexually, physically or emotionally abused by anyone while in care in the facility nor have they heard or witnessed other Clients been sexually, physically or emotionally abused by anyone while in care in the facility. The department also interviewed the alleged victim and asked the alleged victim if alleged victim felt safe at the Hamilton Villa or if anybody had hurt the alleged victim. Alleged victim answered by saying that alleged victim was happy and safe.

Based on LPA's and the department's interviews, the investigation revealed: Although the allegations 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 are unsubstantiated.

Exit interview conducted with Adela Santos and a copy of this report provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kruz Long
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2