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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601246
Report Date: 10/18/2023
Date Signed: 10/18/2023 04:29:19 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
10/02/2023 and conducted by Evaluator Kimberly Ramirez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20231002104307
FACILITY NAME:CLIMB, INC. - ARF 4FACILITY NUMBER:
198601246
ADMINISTRATOR:ANNETTE KYAMPAIREFACILITY TYPE:
735
ADDRESS:2315 S. STRANAHAN DRTELEPHONE:
(626) 281-8441
CITY:ALHAMBRASTATE: CAZIP CODE:
91803
CAPACITY:4CENSUS: 4DATE:
10/18/2023
UNANNOUNCEDTIME BEGAN:
04:10 PM
MET WITH:Diane MurriettaTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff did not allow client in care to finish their meal.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted a subsequent complaint visit on 10/18/23 to deliver findings. LPA Ramirez was met by Direct Support Staff (DSP) Diane Murrietta and explained the purpose of the visit.

The investigation consisted of the following: LPA Ramirez conducted initial complaint visit on 10/05/23 and a needs further was required. LPA Ramirez requested and obtained copies of Staff Roster (LIC 500), Resident Roster (LIC 9020), Staff #1 - 4 interviews (S1 – S4), attempted interviews of Staff# 5 (S5), copies of clients #1 and 2 (C1- C2) physician report, face sheet, client activities schedule, weekly snack menu, other pertinent documents and physical plant tour.

See 9099-C for continuation.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
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 2
Control Number 28-AS-20231002104307
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: CLIMB, INC. - ARF 4
FACILITY NUMBER: 198601246
VISIT DATE: 10/18/2023
NARRATIVE
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Allegation: “Staff did not allow client in care to finish their meal.”- It is alleged staff threw away C1’s dinner and did not provide C1 with dessert as required. Two (2) out of the three (3) staff interviewed deny this allegation. LPA Ramirez reviewed facility meal menu and facility weekly snack menu. Per facility snack menu, all clients will receive snacks in the afternoon and an evening snack. Per facility meal menu, all clients will receive dessert after their dinner. Per staff interviews, all clients are given dessert according to facility meal menu however, clients may choose any dessert item the facility has available. Due to clients in care being non-verbal, LPA Ramirez was unable to interview clients in care. LPA Ramirez observed sufficient supply of 2 days of perishables and 7-day supply on non-perishables. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview was conducted with Direct Support Staff (DSP) Diane Murrietta . A copy of this report and appeals rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2