198601216-9-14-2021-11-AS-JHAD-C7AMKA-20210928094022

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601216
Report Date: 09/14/2021
Date Signed: 09/14/2021 04:12:26 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 DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2020 and conducted by Evaluator Martessa Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20201105162602

FACILITY NAME:	STARCARE RESIDENTIAL LLC		FACILITY NUMBER:	198601216
ADMINISTRATOR:	FRED FLUKER		FACILITY TYPE:	735
ADDRESS:	226 S. MATTHISEN ST.		TELEPHONE:	(424) 785-8516
CITY:	COMPTON	STATE: CA	ZIP CODE:	90220
CAPACITY:	4	CENSUS:	DATE:	09/14/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Candice Mccrutchin		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff neglect resulting in resident being malnourished.

INVESTIGATION FINDINGS:

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On 9/14/21 at 2:00 pm, Licensing Program Analyst (LPA) Martessa brown conducted a subsequent visit in order to render investigation findings. LPA met with Candice Mccrutchin, Staff and the purpose of the visit was disclosed.

The investigation consisted of the following:
On 11/6/20, LPA Brown conducted a Health and Safety check. LPA conducted an interview with Fred Fluker, the administrator. During visit LPA requested the following documents: copies of Staff & Client Roster and files. LPA request any related incident reports and medical records.

Regarding allegation: Staff neglect resulting in resident being malnourished.
On 1/6/21 LPA conducted interview with Administrator Fred Fluker regarding the above allegation, He stated residents are provided 3 meals a day and snacks. He stated, notice a change with C1 appetite in the past 6 months. He stated C1’s weight loss has been gradually.
LIC 9099-C is on the next page

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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 11-AS-20201105162602

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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: STARCARE RESIDENTIAL LLC	FACILITY NUMBER: 198601216
	VISIT DATE: 09/14/2021

NARRATIVE

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He stated staff would encourage C1 to eat. He stated C1 has history of substance abuse and counselor was aware. Administrator stated they did not send reports to CCL regarding C1 incidents. Administrator stated C1 has been seen by doctors regarding his other health issues and changes. On 5/24/2021 LPA interviewed assistant administrator regarding the above allegation. She stated R1 has a history of using drugs in the community, but they will try to redirect him. She stated C1 leaves the home around 9 am to 10 am and will eat breakfast and returns around 2-3 pm and will eat lunch and then dinner. She stated C1’s weight always fluctuates. She stated over a period of time C1 lost 41 pounds but that is normal due to C1’s weight fluctuates. On 7/2/21 and 7/16/21, LPA interview staff #S1-#S3 regarding the above allegation. Staff stated they did not notice any changes with C1’s weight. Staff stated C1 will snack a lot and eat dinner. Staff stated if C1 is under the influence will not eat. Staff stated will encourage C1 to eat while under the influence and will document C1’s behavior. Staff stated clients are provided 3 meals a day with snacks but sometimes residents will go out to eat. Staff. On 7/16/21, LPA interview Clients #C1-#C4 regarding the above allegation. Clients stated they are provided 3 meals at the facility and including snack. Clients stated they have jobs or sometimes leave out and will get something to eat. Clients stated they had no problems with receiving food in the facility.

LPA reviewed C1’s weight record and it showed that C1’s weight fluctuates. LPA reviewed C1’s medical history and records show C1 was malnourish but indicated his weight lost may be due to his medical condition and substance abuse.

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.

An exit interview was conducted with Candice Mccrutchin, and a hard copy was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC9099 (FAS) - (06/04)

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