198601069-6-1-2022-28-AS-FFIS-CHM2X8-20220824174640

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601069
Report Date: 06/01/2022
Date Signed: 06/01/2022 10:08:13 AM

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
05/27/2022 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20220527082359

FACILITY NAME:	BONNIE'S GUEST HOUSE INC.		FACILITY NUMBER:	198601069
ADMINISTRATOR:	ALVARADO, DESIREE		FACILITY TYPE:	735
ADDRESS:	135 NORTH BONNIE AVENUE		TELEPHONE:	(626) 440-0494
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY:	14	CENSUS: 13	DATE:	06/01/2022
		UNANNOUNCED	TIME BEGAN:	08:37 AM
MET WITH:	Maviric Nacorda - Direct Care Staff Desiree Alvarado - Administrator		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility phone is in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst(s)(LPA) Mary Flores conducted an unannounced complaint investigation visit regarding the above allegation(s). LPA Flores met with Maviric Nacorda Direct Care Staff and explained the reason for the visit. Administrator Desiree Alvarado arrived 30 minutes later.

The investigation consisted of the following: LPA Flores requested copies of staff and client roster. LPA interviewed client #1(C1),#2(C2),#3(C3),#4(C4),#5(C5)#6(C6), administrator, and staff #2(S2). LPA Flores requested copies of telephone bills for the months of March, April, and May 2022 and Facility Resident's In/Out Log for the month of May 2022. LPA tested phone line during the visit.

The investigation revealed the following: Regarding allegation; Facility phone is in disrepair. It is alleged reporting party has been calling for days, no one answers, and can’t leave a message. Interviews with clients revealed 3 out of 6 clients interview stated they have their own cellphone, have use the facility's phone when needed and have not heard of others say they cannot use or receive phone calls.
(CONTINUED ON LIC (9099C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Stefanie Coronel
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

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-20220527082359

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: BONNIE'S GUEST HOUSE INC.	FACILITY NUMBER: 198601069
	VISIT DATE: 06/01/2022

NARRATIVE

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2 out of 6 clients stated to have been able to use the facility's phone and receive phone calls, 1 out of the 2 stated callers have mention to not be able to get a hold of client sometimes. 1 out of 6 residents interview stated to not be sure about facility's phone line accessibility. Interviews with staff revealed 2 out of 2 staff stated phone line is in working condition and has not been out of order and sometimes client may forget to put phone back. LPA Flores called facility's number during the visit and the line is in working condition, it provides 3 options when dial, option number 1 is to contact clients, option number 2 is to contact staff, and option 3 is to leave a voice message to the licensee of the facility. LPA reviewed phone bills for the facility and no concerns were observed.

Although the allegations 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.

Exit interview was conducted with Desiree Alvarado Administrator and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Stefanie Coronel
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

LIC9099 (FAS) - (06/04)

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