198600539-12-20-2022-28-AS-TVAO-CMXQQ6-20230110112146

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 12/20/2022
Date Signed: 12/20/2022 03:05:53 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
06/03/2022 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220603131057

FACILITY NAME:	PICO RIVERA GARDENS		FACILITY NUMBER:	198600539
ADMINISTRATOR:	MEIR SHAUL YITZI TEICHMAN		FACILITY TYPE:	735
ADDRESS:	6525 ROSEMEAD BLVD.		TELEPHONE:	(562) 949-8489
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	185	CENSUS: 166	DATE:	12/20/2022
		UNANNOUNCED	TIME BEGAN:	01:25 PM
MET WITH:	Andrew De Vera, Assistant Administrator		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Neglect/Lack of Supervision leading to client using illegal substances while in care.
Neglect/Lack of Supervision leading to clients being sexually abused by client in care.
Clients are being harassed by client in care.
Client is stealing other client's belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to interview staff and render findings. LPA met with Andrew De Vera, Assistant Administrator, and explained the purpose of the visit.

The investigation consisted of the following:
On 6/6/22, LPA conducted a health & safety check and toured the entire facility. LPA obtained copy of the staff roster, client roster, and documents pertaining to Client #1: Identification and Emergency Information, Admission agreement, Appraisal/Needs and Services Plan, Physician's Report, House rules, MAR log from March 2022 through Present, and any facility notes. Client interviews were held on 8/9/22. During the visit today, LPA interviewed the Administrator and 5 Staff. The Department of Social Services Investigation Bureau (IB) Investigator L. Garcia was assigned to investigate 2 allegations - Neglect/Lack of Supervision leading to Client using illegal substances while in care and Clients being sexually abused by client in care.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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-20220603131057

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: PICO RIVERA GARDENS	FACILITY NUMBER: 198600539
	VISIT DATE: 12/20/2022

NARRATIVE

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The investigation revealed the following:

Allegation - Neglect/Lack of Supervision leading to client using illegal substances while in care. IB Investigator L. Garcia conducted interviews with the reporting party, alleged perpetrator, and facility staff. Client #1 (C-1) denied using any illegal substances at the facility and had been "clean" for a few years now. The reporting party denied ever witnessing C-1 under the influence of illegal drugs. Facility staff have not witnessed C-1 using illegal substances in the facility. They stated there is constant supervision with surveillance cameras installed in the common areas and staff doing their rounds.

Allegation - Neglect/Lack of Supervision leading to clients being sexually abused by client in care. IB investigator L. Garcia conducted interviews with the reporting party, alleged perpetrator, alleged victims, and facility staff. The alleged victims denied being sexually abused by Client #1 (C-1). The statements provided by the reporting party were inconsistent and also denied that C-1 sexual abused or harassed the client. The other alleged victims also denied C-1 sexually abusing or harassing them. They feel safe residing at the facility and do not feel there is an issue with the lack of supervision from staff. Staff interviewed stated they are constantly monitoring clients at the facility.

Allegation - Clients are being harassed by client in care. LPA conducted the investigation on this allegation and interviewed facility staff and clients. Per staff interviews, if they observe any client provoking another client, they would intervene right away to prevent the situation from escalating. They have not received any reports of clients harassing anybody in the facility. LPA interviewed a total of 14 clients. 2 out of the 14 stated they have been harassed by other clients at the facility and reported the cases to the staff. One stated the staff intervened right away and spoke to the client. The rest of the clients have not seen or heard other clients or staff harassing anyone. They stated staff treat them well and show respect.

(Continue on LIC9099C)

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20220603131057

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: PICO RIVERA GARDENS	FACILITY NUMBER: 198600539
	VISIT DATE: 12/20/2022

NARRATIVE

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Allegation - Client is stealing other client's belongings. LPA conducted interviews with staff and clients regarding this allegation. Staff stated that clients have reported missing items from their rooms or in the laundry area. Staff are sometimes able to retrieve their belongings after reviewing the surveillance cameras. Other times, clients will let staff know they have found it in their rooms. Interviews with clients revealed that they have not had anything stolen from them. If they do laundry, they stay with their belongings to prevent any one from taking their things. They stated it is recommended to remain with their clothing during laundry time. 4 out of 14 clients indicated they had something taken from them in the past, mainly due to leaving their clothing unattended while they do their own laundry.

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.

An exit interview was conducted with the Administrator Teichman. A copy of this report along with the appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC9099 (FAS) - (06/04)

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