198600930-1-11-2023-28-AS-RORN-CPAVZJ-20230222155246

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600930
Report Date: 01/11/2023
Date Signed: 01/11/2023 02:40:53 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
09/24/2020 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200924132116

FACILITY NAME:	VICTORIA RESIDENTIAL CARE HOMES		FACILITY NUMBER:	198600930
ADMINISTRATOR:	JOCELYN MANALO		FACILITY TYPE:	735
ADDRESS:	414 S ABELIAN AVE		TELEPHONE:	(626) 913-4707
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91792
CAPACITY:	4	CENSUS: 4	DATE:	01/11/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator Jocelyn Manalo		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff sexually assaulted client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Jocelyn Manalo and explained the reason for the visit.
The purpose of the visit is to deliver the findings from the original complaint dated 09/24/2020.
On 09/28/2020 initial visit was conducted which was a Health and Safety Check. The following was done:
Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, complaint investigation was conducted via tele-video with the facility Administrator Jocelyn Manalo
Tour of the facility was conducted which included 3 Client Bedrooms and 2 Client Bathrooms, living room, dining room, kitchen, laundry room and backyard area.
An investigation was conducted by the Investigations Branch (IB) from the Department of Social Services and completed 12/19/2022 and included the following:
Obtaining and reviewing documents from the facility, documentation from Los Angeles Sheriff's Department Report URN # 0920-06230-2945-444 and interviews with former Staff S (1), and Resident's R

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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-20200924132116

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: VICTORIA RESIDENTIAL CARE HOMES	FACILITY NUMBER: 198600930
	VISIT DATE: 01/11/2023

NARRATIVE

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(1) and R (2).
In regards to the allegation Staff sexually assaulted client, based on interviews conducted and information gathered R (1) on 12/13/2022 stated throughout the interview inconsistent statements such as S (1) touched her inappropriately last week.
S (1) has not been employed at the facility since 09/2020.
It was revealed by deputy from Los Angeles Sheriff's Department Report URN # 0920-06230-2945-444 that R(1) was interviewed by the deputy on 10/05/2020 at the facility.
Report stated that based on inconsistent statements from R (1) that deputy was not able to determine if a crime had occurred.
On 12/13/2022 S (1) was interviewed and denied touching S (1) or any of the residents inappropriately.

Based upon document review and interviews conducted the findings indicate that, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC9099 (FAS) - (06/04)

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