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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601301
Report Date: 04/01/2025
Date Signed: 04/01/2025 03:23:54 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
03/24/2025 and conducted by Evaluator Daniel Konishi
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250324114325
FACILITY NAME:AIM HIGHER COVINAFACILITY NUMBER:
198601301
ADMINISTRATOR:GUADALUPE RODRIGUEZFACILITY TYPE:
775
ADDRESS:440 SOUTH CITRUS AVETELEPHONE:
(626) 339-0400
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY:80CENSUS: 54DATE:
04/01/2025
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Amiel Salgado, Program DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Daniel Konishi conducted an initial 10-day complaint visit to ascertain information pertaining to the above-mentioned allegation(s) and to establish the validity of the complaint.
LPA met with Program Director Amiel Salgado allowed entry into the facility and assisted with the visit.

The investigation consisted of the following: On today's date, LPA interviewed the program director, Staff #1 (S1) to Staff #4 (S4) and Client#1 (C1) to Client#7 (C7) in the facility. LPA also obtained the client's roster, staff roster, and the Program Design.

The investigation revealed of the following: Allegation: "Facility is operating out of ratio.” It’s alleged that client to staff ratio is supposed to be 4:1, however there was an incident 2-3 weeks ago (date unknown) in which the ratio increased dramatically to 10:1 due to understaffing. It is also alleged that facility is working on hiring additional employees to meet staffing needs.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Daniel Konishi
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
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 3
Control Number 28-AS-20250324114325
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: AIM HIGHER COVINA
FACILITY NUMBER: 198601301
VISIT DATE: 04/01/2025
NARRATIVE
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Program Director and 4 out of 4 staff interviewed confirmed the allegation of not meeting client to staff ratio. 6 out of 7 clients interviewed denied the allegations. 1 out of 7 clients interviewed stated not knowing if the facility is short staffed. However, all clients stated being helped by staff when needed and feel safe at the facility. All staff interviewed stated the facility is short staffed and staffing ratios were not met in previous instances. The program director stated that to ensure that they are complaint with client to staff ratio, the program director and assistant director are on the floor to help staff. The program director provided documentation that the facility was operating on the 4 clients to 1 staff ratio on the day of the visit. Program director also stated that there are working on additional staff. However, interviews conducted with 4 out of 4 staff confirmed that client to staff ratios have not been met. Also having the program director being part of the floor staff can potentially affect his administrative duties. Program director confirmed that there were times when the client to staff ratios were not met.

Based on LPAs observations and interviews which were conducted, record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, and Chapter 3 are being cited on the attached LIC 9099D.

Exit interview held and a copy of the report and Appeal Rights were provided to the Program Director Amiel Salgado.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Daniel Konishi
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20250324114325
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: AIM HIGHER COVINA
FACILITY NUMBER: 198601301
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2025
Section Cited
CCR
82065.5(a)(1)
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(a) Whenever a client who relies upon others to perform all activities of daily living is present, the following minimum staffing requirements shall be met: (1) For Regional Center clients, staffing shall be maintained as specified by the Regional Center.

This requirement is not met as evidenced by:
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Program Director will submit a written plan explaining how facility will ensure that staffing ratios are met moving forward to the LPA by the POC due date.
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Based on interviews and record review, there was confirmation on prior instances in which the facility did not meet client to staff ratio which poses a potential health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Daniel Konishi
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3