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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601425
Report Date: 09/28/2021
Date Signed: 09/28/2021 03:48:02 PM

Substantiated


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 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
10/13/2020 and conducted by Evaluator Joe Katrdzhyan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20201013114215
FACILITY NAME:RHEMA CARE GROUP LLCFACILITY NUMBER:
198601425
ADMINISTRATOR:ANGELA NWAKAFACILITY TYPE:
735
ADDRESS:975 BARSTON AVETELEPHONE:
(626) 324-3134
CITY:COVINASTATE: CAZIP CODE:
91724
CAPACITY:4CENSUS: 4DATE:
09/28/2021
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Staff / Emmanuel Abe & Rosemary Edeh
Administrator / Angela Nwaka		TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff poured water on a client while in care
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Joe Katrdzhyan and Luis Mora conducted an unannounced follow up visit to this facility to deliver findings on the above mentioned allegation of "Staff poured water on a client while in care ". Upon arriving at the facility, LPAs met with Staff / Emmanuel Abe and Rosemary Edeh and were later joined by the Administrator / Angela Nwaka who assisted with the visit.

LPA Katrdzhyan conducted a prior visit (telephonic) to this facility on 10/20/20, in reference to the allegation listed above. During the course of the investigation, LPA conducted interviews of various persons to include the Administrator, Staff members 1 and 2 (S1 and S2), Mother of Client 1 (C1), Sister of C1 and Service Coordinator from San Gabriel/Pomona Regional Center (SGPRC). LPA was unable to inteview C1 as C1 is non-verbal. LPA also reviewed and obtained copies of the following documents in reference to C1;
• Functional Capability Assessment • Appraisal/Needs and Services Plan • Physician’s Report
• Individual Program Plan • Identification And Emergency Information • Employment Application for Staff #1
• Personnel Record for Staff #1 and • Prior write ups / disciplinary actions against Staff #1.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
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-20201013114215
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: RHEMA CARE GROUP LLC
FACILITY NUMBER: 198601425
VISIT DATE: 09/28/2021
NARRATIVE
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The investigation revealed the following;
Allegation: Staff poured water on a client while in care. The details of this allegation states that during a visit at the facility by the family of C1, C1 was observed having a behavior. When S1 came out to assist C1, S1 offered C1 cookies and when that did not work, S1 poured water on C1 and when that did not work, S1 grabbed the garden hose but was stopped by the family of C1.

Based on interviews conducted and record reviews, the incident involving S1 and C1 happened on 10/11/2020, at approximately 1:30PM, outside by the patio area. The mother and sister of C1 were visiting C1 at the time of the incident and observed C1 having a behavior by hitting himself and throwing himself to the ground. S1 came outside and offered C1 cookies to help stop C1 from having behaviors and when that did not work, S1 went inside and brought a cup of water and started pouring the water in her hand and throwing it on C1. As C1 continued with his behaviors, S1 was observed going towards the garden hose but before S1 was able to get a hold of the garden hose the sister and mother of C1 stopped S1 from further trying to assist C1. Based on statements obtained, it seemed as if S1 was trying to grab the garden hose and throw additional water at C1. According to the Administrator, she was informed about the incident from the Service Coordinator at SGPRC on 10/12/21 and S1 was terminated from employment effective 10/13/2020. Per the Administrator, SGPRC conducted an investigation regarding the incident involving S1 and C1 and the outcome was substantiated and therefore S1 was terminated.

Based on LPA’s observations and interviews which were conducted and 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 & Chapter number), are being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of this report was provided to the Administrator along with the Appeals Rights.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20201013114215
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: RHEMA CARE GROUP LLC
FACILITY NUMBER: 198601425
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/28/2021
Section Cited
CCR
80072(a)(3)
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Personal Rights. Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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S1 was terminated from employment effective 10/13/2020 due to the incident involving C1 and no longer works for any of the Licensee's facilities.

Citation was cleared at the time of visit, no further actions is needed.
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This requirement is not met as evidenced by;
On 10/11/2020, at approximately 1:30PM, S1 was observed by the sister and mother of C1 pouring water in her hand and throwing it on C1 as a way of controlling C1 from having behaviors. This is a violation of personal rights.
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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: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3