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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601372
Report Date: 02/08/2024
Date Signed: 02/08/2024 01:17:03 PM

Substantiated


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
02/01/2024 and conducted by Evaluator Mary G Flores
COMPLAINT CONTROL NUMBER: 28-AS-20240201100713
FACILITY NAME:ONE STEP AHEAD DAY PROGRAMFACILITY NUMBER:
198601372
ADMINISTRATOR:HAMILTON, MARKFACILITY TYPE:
775
ADDRESS:421 DEL MONTE STTELEPHONE:
(626) 794-4103
CITY:PASADENASTATE: CAZIP CODE:
91103
CAPACITY:60CENSUS: 34DATE:
02/08/2024
UNANNOUNCEDTIME BEGAN:
12:58 PM
MET WITH:Cheryl Jackson - Program Supervisor TIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff hit client with an object
Staff yelled at client
INVESTIGATION FINDINGS:
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*This report is a corrected report for report created on 2/8/24 to provided the correct deficiency section number on LIC 9099D*

Licensing Program Analyst (LPA) Mary Flores and Investigator (IB) Johny Canto conducted an unannounced complaint investigation visit regarding the above allegations. LPA met with Cheryl Jackson and explained the reason for the complaint.

The investigation consisted of the following: LPA requested a copy of staff and client roster. Review client #1(C1)’s file, conducted interviews with 4 staff and 5 clients, requested copies of C1’s physician’s report, face sheet, behavior intervention plan, individual program plan. Staff #1(S1)’s personnel report, health screening, policy regarding client abuse, in-service training orientation, statement of duties. LPA interviewed S1 over the phone.
(CONTINUED ON LIC 9099C)
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
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 3
Control Number 28-AS-20240201100713
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: ONE STEP AHEAD DAY PROGRAM
FACILITY NUMBER: 198601372
VISIT DATE: 02/08/2024
NARRATIVE
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The investigation revealed the following: Regarding allegations: Staff hit client with an object and Staff yelled at client. It is alleged staff #1(S1) hit C1 on top of the head with a plastic water bottle while shouting “get out of there”. Interviews with clients revealed 2 out of 5 clients interviewed stated that S1 has yelled at clients at times to redirect the clients. 1 out of the 2 stated to have witness the incident and S1 did tap C1 in the head with a water bottle that contained water in it. 2 out of 5 clients stated S1 treats clients with respect. 1 out of 5 clients was unable to be interviewed due to cognitive issues. Interviews with staff revealed the following, 1 out of 5 staff interviewed stated to have witnessed the incident and S1 was attempting to redirect C1 from eating from the trash can. C1 did not use a proper technique to redirect C1 by tapping C1 with a water bottle that contained water in it and yelling to get out of there. Staff stated it was out of character for S1 to react in that matter. Clients are not afraid of S1 and usually engaged with S1 in a positive way. If staff has used a loud tone of voice it has been to redirect clients and not in a malicious way. During interview with S1, S1 admitted to have tap C1 with the water bottle in the head as S1 was trying to redirect C1 from eating from the trash can and yell to “get out of the way and out of there”. Regional Center Services Coordinator was present at the time of the incident and witness S1 use the water bottle that contained water to tap C1 on the head and yell at C1. There is no history of recurrent behavior by S1. S1 has received training on client rights in 2017.

Based on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.

Exit interview was conducted with Greg Tillman and provided a copy of this report, LIC 9099D, and appeal rights.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240201100713
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: ONE STEP AHEAD DAY PROGRAM
FACILITY NUMBER: 198601372
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/09/2024
Section Cited
CCR
82072(a)(1)
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82072 Personal Rights (a) Each client shall have personal rights which include, but are not limited to, the following:(1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement is not met as evidence by:
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Program Director will provide training to staff regarding client personal rights and will clarify staff's duties and responsibilities with S1 in writing and will provide a copy of both training and duties by POC due date 2/9/24.
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Based on documents review and interviews licensee did not ensure that S1 redirected C1 without yelling at C1 which poses an immediate risk to the health, personal rights, or safety of the persons in care.
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Type A
02/09/2024
Section Cited
CCR
82072(a)(3)
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82072 Personal Rights (a) Each client shall have personal rights which include, but are not limited to, the following: 3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule...
This requirement is not met as evidence by:
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Program Director will provide training to staff regarding client personal rights and will clarify staff's duties and responsibilities with S1 in writing and will provide a copy of both training and duties by POC due date 2/9/24.
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Based on documents review and interviews licensee did not ensure that S1 redirected C1 without tapping C1 with a fill water bottle which poses an immediate risk to the health, personal rights, or safety of the 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: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3