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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601158
Report Date: 10/25/2024
Date Signed: 10/25/2024 10:42:33 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/09/2024 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20241009165047
FACILITY NAME:VINTAGE HOUSEFACILITY NUMBER:
198601158
ADMINISTRATOR:KARLTON A. LEVIASFACILITY TYPE:
735
ADDRESS:717 SOUTH BRADFIELD STREETTELEPHONE:
(424) 338-6422
CITY:COMPTONSTATE: CAZIP CODE:
90221
CAPACITY:4CENSUS: 4DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:DSP Gwendolyn GreenTIME COMPLETED:
01:31 PM
ALLEGATION(S):
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Residents are being brokered and housed outside of the facility by staff.
Staff left resident's unattended.
INVESTIGATION FINDINGS:
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On 10/12524 Licensing program analyst (LPA) Villegas conducted a subsequent complaint to render findings. LPA met with DSP Gwendolyn Green as the purpose of today's visit was explained.

The investigation consisted of the following: On 10/16/24 LPA obtain copies of the staff and client rosters, direct care staff schedule, day program info, and contact info for South Central Regional Center service coordinator. On 10/16/24 LPA conducted a tour of the facility and there are no immediate health and safety concerns, between 9:30 am-12 pm LPA conducted interviews with staff# 1-4 (S1-S4), between 12 pm- 2:25 pm interviews were conducted with clients #1-3 (C1-C3). On 10/22/24 LPA Villegas conducted interview with client # 4 (C4) and witness 1 (W1) between 1:10pm- 1:21pm.

The investigation revealed the following:
Allegation: Residents are being brokered and housed outside of the facility by staff.
It is being alleged that the licensee is brokering out clients to live with other people that do not operate
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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 11-AS-20241009165047
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: VINTAGE HOUSE
FACILITY NUMBER: 198601158
VISIT DATE: 10/25/2024
NARRATIVE
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ARFs in Victorville, CA. On 10/16/24 between 9:30 am-12 pm LPA conducted an interview with S1 regarding the allegation above, S1 denied the allegation above. Per S1 there is a drug program that clients attend which is in Victorville, CA however clients are not brokered nor housed in Victorville, CA. On 10/16/24 between 9:30 am-12 pm LPA conducted interviews with (S2-S4), 3 of 3 staff interviewed denied the allegation above and reported there have been no discharges in the last year. On 10/16/24 and 10/22/24 LPA called W1 regarding the allegation above, W1 denied the allegation above and reported W1 and SCLAR are aware clients attend a drug rehad program located in Victoville, CA. On 10/16/24 between 12 pm- 2:25 pm LPA conducted interviews with C1-C3, and on 10/22/24 LPA conducted interview with client # 4 (C4). 4 of 4 clients interviewed denied the allegation above.

Allegation: Staff left residents unattended.

It is being alleged that clients are sometimes left with 1 staff for the entire weekend. On 10/16/24 between 9:30 am-12 pm LPA conducted an interview with S1 regarding the allegation above, S1 denied the allegation above. Per S1 there is a 1 staff per 2 clients ration per shift due to extreme level of behaviors. On 10/16/24 between 9:30 am-12 pm LPA conducted interviews with (S2-S4), 3 of 3 staff interviewed denied the allegation above and reported there are 2 staff per shift. On 10/16/24 between 12 pm- 2:25 pm interviews were conducted with C1-C3, and on 10/22/24 LPA conducted interview with client # 4 (C4). 4 of 4 clients interviewed denied the allegation above and reported never being left unattended.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted with DSP Gwendolyn Green, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2