198601223-2-11-2023-11-AS-MVAO-CPNV2Y-20230306150356

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601223
Report Date: 02/11/2023
Date Signed: 02/11/2023 03:18:04 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
02/25/2022 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220225084441

FACILITY NAME:	BRIDGE II ADULT RESIDENTIAL FACILITY		FACILITY NUMBER:	198601223
ADMINISTRATOR:	AISHA ANDREWS		FACILITY TYPE:	735
ADDRESS:	4935 W. 136TH STREET		TELEPHONE:	(310) 679-8977
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	6	CENSUS: 6	DATE:	02/11/2023
		UNANNOUNCED	TIME BEGAN:	12:57 PM
MET WITH:	Debra Davenport		TIME COMPLETED:	03:01 PM

ALLEGATION(S):

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Resident is being sexually abused while in care.
Resident's dental needs not being met.
Resident is not being fed a sufficient amount of food while in care.
Resident is being threatened while in care.
Resident's clothing needs are not being met while in care.
Resident's personal possessions are not being safeguarded while in care.
Resident's bathing needs not being met while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ernand Dabuet made an unannounced visit to the facility and was greeted by house manager (S1) Debra Davenport. LPA conducted a risk assessment prior to entering facility. Davenport informed LPA that the facility has no COVID cases nor do any of the clients or staff have symptoms. The purpose for today’s visit is to conduct a subsequent visit and deliver the findings pertaining to the above-mentioned allegation(s).

An initial 24-hour visit was conducted by LPA Jey Cardenas on 02/25/22 with Staff #1 (S2: Markeisha Findley) and Back-up Administrator/House Manager (S1: Deborah Davenport); as Administrator was unavailable.

On 7/12/2022 LPA Jeyde Cardenas interviewed Staff #1 (S1), Staff #3 (S3), Witness #1 (W1), Clients #4 - #6 (C4, C5, C6), an attempted interview with Client #1 (C1) who refused - using profanity, and Client #2 (C2) and Client #3 (C3) who were non-verbal. LPA/RA Elizabeth Ceniceros reviewed (between 2:00 p.m. – 3:00 p.m.) on 12/29/22 the pertinent documents: Admissions Agreement, Emergency I.D. & Info, Physician’s Report (dated 04/06/20),
(Evaluation Report Continues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2023

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 5

Control Number 11-AS-20220225084441

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRIDGE II ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 198601223
	VISIT DATE: 02/11/2023

NARRATIVE

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Individual Personal Plan (IPP), Medication Administration Record (MAR), Unusual Incident/Injury Report(s), and Safeguard for Property/Valuables for Client #1 (C1); including: facility staff work schedules, training records, facility menu, housekeeping laundry schedule, and facility staff & clients rosters.

INVESTIGATION REVEALED THE FOLLOWING:

Regarding Allegation #1: this investigation revealed that local law enforcement arrived at the facility on 02/25/22 and asked to talk to Client #1. Once outside the facility, Client #1 became agitated and began using profanity towards the police officers. There was no follow-up investigation or police report generated regarding facility staff sexually abusing Client #1. LPA Jeyde Cardenas conducted staff interviews who corroborated that facility staff have never sexually abused Client #1 nor observed a staff member sexually abuse Client #1. Interviews conducted of clients in care corroborated that they have not observed facility staff sexually abuse Client #1. Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. Interviews conducted of witnesses corroborated that there was no report from clients in care or investigation conducted by the regional center of facility staff regarding sexual abuse to clients in care nor an internal investigation into the allegation of sexual abuse to Client #1.

Based on the evidence gathered and interviews conducted and records reviewed, 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 of SEXUAL ABUSE: Resident is being sexually abused while in care is found to be UNSUBSTANTIATED.

Regarding Allegation #2: this investigation revealed that when the pandemic hit, Client #1’s dental office closed down and once it re-opened, they were very backed up with patients requiring dental work. LPA Jeyde Cardenas conducted staff interviews who corroborated that the clients go to the dentist every year. As of January 2022, the facility had been on a waiting list – awaiting to be scheduled for Client #1’s dental appointment. Interviews conducted of clients in care corroborated that they had been going to the dentist until the pandemic hit; and, they were receiving visits to their dentist prior to the pandemic. Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. LPA observed a dental appointment document on 01/20/21 for Client #1 with the L.A. Care Group. Interviews conducted of witnesses corroborated that Client #1 does go to their dental appointment(s); however, Client #1 tends to become agitated and uncooperative.

(Evaluation Report Continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2023

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 11-AS-20220225084441

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRIDGE II ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 198601223
	VISIT DATE: 02/11/2023

NARRATIVE

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Based on the evidence gathered and interviews conducted and records reviewed, 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 of NEGLECT/LACK OF SUPERVISION: Resident’s dental needs not being met is found to be UNSUBSTANTIATED.

Regarding Allegation #3: this investigation revealed that the facility maintains a grocery list to replenish the food supply every week. LPA Jeyde Cardenas conducted staff interviews who corroborated that none of the clients in care have expressed concerns regarding the quantity of food. Interviews conducted of clients in care corroborated that they get three (3) meals a day and snacks in between meals. There is always plenty of food; and, they are not left hungry after each meal. Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. Interviews conducted of witnesses corroborated that there has been no complaint regarding the quantity or quality of food from the clients in care. Client #1 physician reports documented that Client #1 is able to feed oneself and that the client’s weight fluctuates between 110 – 121 lbs and has “weight issues/skips meals.” LPA toured the kitchen and observed an appropriate food supply and compared the perishable & non-perishable food supply with the facility’s weekly menu and found it to be a sufficient food supply.

Based on the evidence gathered and interviews conducted and records reviewed, 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 of FOOD SERVICE: Resident is not being fed a sufficient amount of food while in care is found to be UNSUBSTANTIATED.

Regarding Allegation #4: this investigation revealed that Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. LPA conducted staff interviews who corroborated that they had not received complaints from clients in care that they were being threatened by facility staff nor had they observed facility staff threaten Client #1. Interviews conducted of clients in care corroborated that they do not feel threatened by a facility staff member(s) nor from other clients in care; and, they did not observe a facility staff member threaten Client #1. Interviews conducted of witnesses corroborated that they had not received a complaint from their clients in care that facility staff are threatening Client #1 or clients in care and feel unsafe. LPA reviewed the facility’s staff training log on the topics of Personal Rights and Mandated Reporter.

(Evaluation Report Continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20220225084441

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRIDGE II ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 198601223
	VISIT DATE: 02/11/2023

NARRATIVE

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Based on the evidence gathered and interviews conducted and records reviewed, 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 of PERSONAL RIGHTS: Resident is being threatened while in care is found to be UNSUBSTANTIATED.

Regarding Allegation #5: this investigation revealed that the facility does the laundry for clients in care; however, it is the responsibility of the clients in care to put their clothes away in their closet or drawer. LPA Jeyde Cardenas conducted staff interviews who corroborated that they had not received a complaint that clients in care clothing needs are not being met. Interviews conducted of clients in care corroborated that their clothing needs are being met by facility staff. Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. Interviews conducted of witnesses corroborated that no complaint had been filed with the regional center regarding clients in care clothing needs are not being met by the facility. LPA reviewed the housekeeping laundry schedule.

Based on the evidence gathered and interviews conducted and records reviewed, 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 of PERSONAL RIGHTS: Resident’s clothing needs are not being met while in care is found to be UNSUBSTANTIATED.

Regarding Allegation #6: this investigation revealed that the facility maintains an inventory of clients in care personal possession(s). LPA Jeyde Cardenas conducted staff interviews who corroborated that they had not received complaints from clients in care that their personal possessions are not being safeguarded by facility nor observed facility staff stealing Client #1’s personal possessions. Interviews conducted of clients in care corroborated that they had not had their personal possession(s) missing or stolen from their person by facility staff nor observed facility staff stealing Client #1’s personal possessions. Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. Interviews conducted of witnesses corroborated that no complaint had been filed by a client in care that they were missing personal possessions or had them stolen from their person by a facility staff member. LPA reviewed clients Safeguard for Property/Valuables.

(Evaluation Report Continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20220225084441

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRIDGE II ADULT RESIDENTIAL FACILITY	FACILITY NUMBER: 198601223
	VISIT DATE: 02/11/2023

NARRATIVE

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Based on the evidence gathered and interviews conducted and records reviewed, 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 of PERSONAL RIGHTS: Resident’s personal possessions are not being safeguarded while in care is found to be UNSUBSTANTIATED.

Regarding Allegation #7: this investigation revealed that Client #1’s physician reports documented that Client #1 is able to bathe oneself and care for own personal needs. LPA Jeyde Cardenas conducted staff interviews who corroborated that they had not received complaints that their bathing needs are not being met. Interviews conducted of clients in care corroborated that they are able to bathe themselves without the assistance of facility staff. Client #1 refused to speak to LPA Jeyde Cardenas and walked away using profanity as witnessed by Staff #1. Interviews conducted of witnesses corroborated that they have not received complaints from clients in care regarding their bathing needs not being met.

Based on the evidence gathered and interviews conducted and records reviewed, 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 of PERSONAL RIGHTS: Resident’s bathing needs not being met while in care is found to be UNSUBSTANTIATED.

An exit interview has been conducted and a copy of the Complaint Report provided to House Manager Debra Davenport.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2023

LIC9099 (FAS) - (06/04)

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