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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600654
Report Date: 08/15/2024
Date Signed: 08/15/2024 10:41:23 AM

Substantiated


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
07/31/2024 and conducted by Evaluator Mary G Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240731151941
FACILITY NAME:CONTINENTAL GUEST HOMEFACILITY NUMBER:
198600654
ADMINISTRATOR:RUBERTO BALUYOTFACILITY TYPE:
735
ADDRESS:15482 PASTRANA DRIVETELEPHONE:
(714) 522-3013
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY:4CENSUS: 4DATE:
08/15/2024
UNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Corazon Casanas - Direct Support StaffTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Client's clothing is inaccessible to client
Client's admission agreement is not being adhered to
INVESTIGATION FINDINGS:
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*This report is to replace report dated 8/5/24 to show the changes to the findings for the above allegations.* Licensing Program Analyst (LPA) Mary Flores and Mayra Cota conducted a subsequent unannounced complaint investigation visit regarding the above allegations. LPAs met with Corazon Casanas and explained the reason for the visit.

The investigation consisted of the following: LPA requested a copy of staff/client roster. LPA reviewed medication for (4) clients and observed (4) clients’ bedrooms. LPA requested copies of medication sheets for the month of July and August 2024, physician’s reports, individual program plan, admission agreement, house rules, face sheet, notes for client #1, and #2 (C1-C2), and medications sheets from January 2024 – June 2024 for C2. LPA interviewed 3 staff and 2 clients.

(CONTINUED ON LIC 9099C)
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
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 3
Control Number 28-AS-20240731151941
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: CONTINENTAL GUEST HOME
FACILITY NUMBER: 198600654
VISIT DATE: 08/15/2024
NARRATIVE
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The investigation revealed the following: Regarding allegations: Client’s clothing is inaccessible to the client and Client’s admission agreement is not being adhere to. It is alleged C1 has a tendency to destroy or remove clothes. Therefore, cabinets have been placed facing the wall making them inaccessible to the client and it is alleged the facility is not following the HCBS final ruling for accessibility to personal items. Interviews with staff revealed that C2 began to put dirty diapers inside the clean clothes drawers some months ago and throwing the clothes in the floor some weeks ago. Staff in order to prevent client placing dirty items inside the drawers decided to turn the dresser to face the wall. Administrator stated facility staff is adjusting to the new HCBS final ruling and will provide training to staff regarding HCBS final ruling in the following month. After the Regional Center’s visit, administrator contacted the service coordinator for guidance. Service Coordinator will hold a meeting on August 14th and will discuss then how to best assist with the behaviors. Interviews with clients revealed the clients have access and choice to what they will wear each day and have no concerns regarding accessing their personal belongings. Staff were able to identify personal rights regarding clients choosing what to wear and other personal rights. During facility’s tour, LPA observed C1 and C2’s share bedroom; clients’ clothes were observed hanging in the closet as well as their clothes placed in the drawers of each client’s dressers, which are now accessible to the clients.
Documents reviewed revealed staff have noted that C2 had begun to place worn underwear in clean clothes drawers for the first time on 3/16/24. On 4/20/24, staff noted C2 place a dirty adult brief either inside the closet, cabinet and was mixing it with the clean clothes. IPP does not note or address the behavior seen by staff noticed by C2. LPA did not observed modifications done to the IPP regarding the current behavior(s). Although, staff allow the clients to choose what they will wear each day as they are assisting with activities of daily living. Clients should have access to all their personal belongings at all times. Therefore, the allegation is substantiated.

Based on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.

Exit interview was conducted and a copy of this report, LIC 9099D, and appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240731151941
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: CONTINENTAL GUEST HOME
FACILITY NUMBER: 198600654
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/16/2024
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights: (a)... each client shall have personal rights...: (3) To... interference with the daily living functions, ...; or withholding of shelter, clothing, medication or aids to physical functioning.

This requirement is not met as evidence by:
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Administrator will provide training on HCBS final ruling to staff and will work with the Regional Center to provide modifications to the IPP will provide copies of the training signing log and copy of modifications to the department by POC due date 8/16/24.
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Based on observation, interviews, and documents reviewed licensee did not ensure C1 and C2 had access to their clothing and their personal rights were met at all times which poses an immediate risk to the health, safety, personal rights of the persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2024
LIC9099 (FAS) - (06/04)
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