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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600271
Report Date: 09/29/2023
Date Signed: 09/29/2023 02:14:28 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
08/01/2023 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230801100312
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: 62DATE:
09/29/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Adela SantosTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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9
Personal Rights/Client in care was sexually assaulted.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to investigate the above allegation. LPA met with Adela Santos and explained the purpose of today’s visit.

On 08/02/23, LPA Irra conducted the initial 10-day complaint visit. LPA met with Adela Santos. During this visit, LPA conducted a tour of this facility. LPA did not observe any signs of neglect, abuse or other immediate health and safety threats. LPA reviewed Client #1 (C-1) file and obtained relevant documentation. LPA obtained copies of the client and staff rosters.

During this investigation, Investigator Dennis Douglas (CCLD-Investigation Branch) interviewed C-1, Facility Administrator/S-1 and Facility Staff Member/S-2. LPA Irra interviewed Client #2 (C-2) through Client #5 (C-5) and Staff #3 (S-3) through Staff #4 (S-4)

Refer to LIC 9099C for the continuation of this report.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2023
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-20230801100312
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: HAMILTON VILLA
FACILITY NUMBER: 198600271
VISIT DATE: 09/29/2023
NARRATIVE
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Allegation: Personal Rights/Client in care was sexually assaulted. Per Investigator Dennis Douglas’ report, per Facility Administrator interview, C-1 had previously alleged sexual abuse in which CCLD investigated. Staff Member/S-2 indicated S-2 has not witnessed any sexual abuse/assaults. LPA interviewed C-2 through C-5. Per client interviews, they have not heard nor witnessed any clients being sexually assaulted. LPA interviewed S-3 through S-4. Per staff interviews, they have not heard nor witnessed any clients being sexually assaulted. Interviewed staff indicated they are trained in client rights and mandated reporting. Per Administrator, CCLD previously investigated a similar allegation (February 2023) from C-1 and the finding was unsubstantiated. Per staff interviews, C-1 has a history of fabricating stories. Client and staff interviews do not corroborate this allegation.

Based on record review and interviews conducted the findings indicate, although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.



An exit interview conducted, appeal rights and a copy of this report was provided to Adela Santos.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2