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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600775
Report Date: 09/10/2024
Date Signed: 09/10/2024 05:08:34 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
05/10/2024 and conducted by Evaluator Tyler Reyes
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240510120918
FACILITY NAME:STRATA BELLA (NORWALK) CORPORATIONFACILITY NUMBER:
198600775
ADMINISTRATOR:RUDY DEOCAMPOFACILITY TYPE:
735
ADDRESS:13213 FLALLON AVENUETELEPHONE:
(562) 864-9803
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:4CENSUS: 3DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
09:34 AM
MET WITH:Administrator Assistant Jose Delacruz TIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff hit resident
Staff spoke inappropriately to resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tyler Reyes conducted a follow up complaint investigation regarding the allegations listed above. LPA met with Administrator Jose Delacruz and explained the reason of the visit.

The investigation consisted of the following: during the initial visit conducted on 05/20/24, LPA Wesley requested a copy of staff and client roster. During today’s visit LPA interviewed the Administrator Assistant Jose , toured the facility, and interviewed Client #1 (C1) and Staff #1 (S1) – Staff #5 (S5). LPA attempted to interview C2 however C2 is no longer a resident of the facility and contact information is unknown. Due to C3 and C4's cognitive impairement they were unable to be interviewed. LPA requested copies of C2's personnel records Physician's Report, Face Sheet, IPP, Behavior Services 3rd Quarter Progess Report, and facility staff schedule for the Month of May 2024.

The investigation revealed the following: in regard to the allegation “staff hit resident”, it is alleged that a staff member hit C2 twice in the head. It is alleged C2 was hit once in the facility causing C2’s glasses to fall off their head and a second time in the car. (5) of (5) staff interviewed denied allegation. Staff indicated the following that they have not heard,witnessed, or hit a client.
Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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 2
Control Number 28-AS-20240510120918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: STRATA BELLA (NORWALK) CORPORATION
FACILITY NUMBER: 198600775
VISIT DATE: 09/10/2024
NARRATIVE
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(3) of (5) staff have indicated that C2 has a history of fabrication. LPA obtained copies of C2's IPP and did not observe a history of fabrication. LPA observed on C2's IPP that C2 exhibits a history of self-injurious, aggressive behaviors, and verbal outburst. (1) of (1) client denied the allegation. Client indicated that they have not been hit or witnessed a client being hit. LPA contacted the Harbor Regional Center and their findings were unsubstantiated in regard to staff hitting clients. LPA observed S2 and S4 responding to the clients in a respectful and supportive manner.

The investigation revealed the following: in regard to the allegation “Staff spoke inappropriately to resident”, it is alleged that a staff member responded to C2 not waiting for their arrival that “If you do not want to listen, you can leave my house” and added “ I hope that your new group home hits you all of the time”. (5) of (5) staff interviewed denied allegation. Staff indicated the following that they have not heard, witnessed, or spoke inappropriately to clients. Staff indicated that they speak in a level voice when communicating with clients. (1) of (1) client denied the allegation. Client indicated the they have not heard, witnessed, or been spoken to inappropriately by staff. LPA observed and witnessed S4 speaking to C1 in a in a respective and calm tone.

Based on the interviews conducted, files reviewed, and observations conducted there was not enough supportive evidence to concur with the reported allegation; 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 Interviewed conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2