198601740-11-26-2024-28-AS-DSIS-DBLVR9-20241203153934

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601740
Report Date: 11/26/2024
Date Signed: 11/26/2024 01:53:42 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
11/22/2024 and conducted by Evaluator Erik Zaragoza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241122083048

FACILITY NAME:	QUALITY OF LIFE ACADEMY		FACILITY NUMBER:	198601740
ADMINISTRATOR:	NNAEMEKA EZENAGU		FACILITY TYPE:	775
ADDRESS:	8439 CALIFORNIA AVENUE		TELEPHONE:	(562) 372-4750
CITY:	SOUTH GATE	STATE: CA	ZIP CODE:	90280
CAPACITY:	66	CENSUS: 57	DATE:	11/26/2024
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Joshua Corzantes - Program Director		TIME COMPLETED:	02:07 PM

ALLEGATION(S):

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Staff forces resident to exercise
Staff do not ensure that the facility is sanitary
Staff do not provide residents with personal care items
Staff are not addressing a resident's behavior

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Erik Zaragoza conducted an initial unannounced visit to address the allegations listed above. LPA met with Joshua Corzantes, Program Director for the facility, and explained the purpose of the visit.

The investigation consisted of the following: During today's visit, LPA interviewed Clients #1 - 6 (C1 - C6), Staff #1 - 4 (S1 - S4), obtained copies of the staff and client roster, and also obtained copies of the schedule of activities for the clients as well as the Behavioral Data Sheet for C2. LPA also toured the facility to observe the cleaning supplies, toilet paper supplies, hand soap supplies, and toured all of the restrooms.

The investigation revealed the following: In regards to the allegation that "Staff forces resident to exercise, it is alleged that S2 has been forcing C1 to walk and exercise even though C1 does not want do exercise for the day.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024

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 6

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
11/22/2024 and conducted by Evaluator Erik Zaragoza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241122083048

FACILITY NAME:	QUALITY OF LIFE ACADEMY		FACILITY NUMBER:	198601740
ADMINISTRATOR:	NNAEMEKA EZENAGU		FACILITY TYPE:	775
ADDRESS:	8439 CALIFORNIA AVENUE		TELEPHONE:	(562) 372-4750
CITY:	SOUTH GATE	STATE: CA	ZIP CODE:	90280
CAPACITY:	66	CENSUS: 57	DATE:	11/26/2024
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Joshua Corzantes - Program Director		TIME COMPLETED:	02:07 PM

ALLEGATION(S):

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Staff do not maintain the facility in good repair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Erik Zaragoza conducted an initial unannounced visit to address the allegation listed above. LPA met with Joshua Corzantes, Program Director for the facility, and explained the purpose of the visit.

The investigation consisted of the following: During today's visit, LPA interviewed Clients #1 - 6 (C1 - C6), Staff #1 - 4 (S1 - S4), obtained copies of the staff and client roster, and also obtained copies of the schedule of activities for the clients as well as the Behavioral Data Sheet for C2. LPA also toured the facility to observe the cleaning supplies, toilet paper supplies, hand soap supplies, and toured all of the restrooms.

The investigation revealed the following: In regards to the allegation that "Staff do not maintain the facility in good repair," it is alleged that the toilets in the restrooms have been leaking water and that nothing has yet been done to address the issues.

Substantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 6

Control Number 28-AS-20241122083048

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: QUALITY OF LIFE ACADEMY	FACILITY NUMBER: 198601740
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/26/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/17/2024 Section Cited CCR 82087(a)	1 2 3 4 5 6 7	(a) The program site shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This regulation is not met as evidenced by:	1 2 3 4 5 6 7	Administrator is to ensure that the facility is in good repair at all times. Administrator is to replace the lid to the toilet's water tank lid and submit photographic proof to LPA that it has been replaced by the POC due date.
	8 9 10 11 12 13 14	Based on observation and interview, LPA determined the first client restroom on the left-hand side of the back building has a toilet water tank lid that is currently broken, which poses a potential health and safety risk to clients in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 6

Control Number 28-AS-20241122083048

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: QUALITY OF LIFE ACADEMY	FACILITY NUMBER: 198601740
	VISIT DATE: 11/26/2024

NARRATIVE

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During interviews with the clients, six (6) out of six (6) clients did not corroborated the allegation. One client interviewed stated that if there is a leak in any of the toilets at the facility, they will let staff know and that staff are quick to fix these issues. Another client interviewed stated to their knowledge there were no toilet leaks or other issues with the toilets in the restrooms. During interviews with the staff, four (4) out of four (4) did not corroborate the allegation. One of the staff interviewed stated that there were no issues with the toilets leaking, however one of the toilets in the back had a tank lid that is missing due to a staff's behavior and that it is in the process of being repaired. Another staff interviewed also confirmed that while there were no issues with leaks in the toilets, the lid for one of the toilets had been removed, and that they have ordered the replacement parts in order to address the issue. During a tour of the the first restroom that is on the left-hand side of the back building of the facility, LPA observed that toilet's water lid tank had been removed and that its internal components of the tank were currently exposed.

Based on LPA interviews conducted with the clients and staff, the preponderance of evidence standard has been met for the above allegations, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 3 is being cited on the attached LIC9099D.

Exit interview held with Program Director Joshua Corzantes. Exit interview was held and a copy of the report along with the appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 6

Control Number 28-AS-20241122083048

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: QUALITY OF LIFE ACADEMY	FACILITY NUMBER: 198601740
	VISIT DATE: 11/26/2024

NARRATIVE

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During interviews with the clients, five (5) out of six (6) interviewed did not corroborate the allegation. During an interview with C1, they stated that whenever they go walking or exercising with staff it is always their own choice, and that they are never forced to do so by any of the staff members. Another client interviewed stated that they also walk and exercise with staff, but they are never forced to do so by staff. During interviews with the staff, four (4) out of four (4) interviewed denied the allegation. S2 stated that they encourage clients to go for their scheduled walks and exercises in a positive manner, however they never force any of the clients to exercise or take walks. Another staff interviewed stated that they take C1 and all other clients out for walks at their own discretion, and that if they do not want to exercise they will not have to. Review of the activities calendar revealed that walking and exercise activities are offered to clients everyday Monday through Friday.

In regards to the allegation that "Staff do not ensure the facility is sanitary," it is alleged that the the facility restrooms are not sanitary because there are no cleaning products at the facility. During interviews with the clients, five (5) out of six (6) did not corroborate the allegation. One of the clients interviewed stated that the restrooms of the facility tend to always be clean and that they witness staff cleaning the restrooms frequently. Another client interviewed stated the bathrooms are clean and that staff do clean them when necessary. During interviews with the staff, four (4) out of four (4) did not corroborate the allegation. One of the staff interviewed stated that the toilets are cleaned regularly, and that after a client uses a restroom, staff always check the restroom to determine if they need to be cleaned. Another staff interviewed stated that restrooms are checked at 9 AM, 11 AM, 1 PM, and at the end of the day to ensure that they are clean. During a tour of the facility, LPA determined that the facility did have cleaning products at the facility and there was a sufficient supply of it.

In regards to the allegation that "Staff do not provide residents with personal care items," it is alleged that staff does not maintain a supply of hand soap, toilet paper, or toilet seat covers for the clients to use. During interviews with the clients, six (6) out of six (6) interviewed did not corroborate the allegation. One of the clients interviewed indicated that toilet paper, toilet seat covers, and hand soap is always available for them in the restrooms. Another client interview also confirmed that they have never had issues with having toilet paper, hand soap, and toilet seat covers available for them when they need to use the restroom.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024

LIC9099 (FAS) - (06/04)

Page: 5 of 6

Control Number 28-AS-20241122083048

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: QUALITY OF LIFE ACADEMY	FACILITY NUMBER: 198601740
	VISIT DATE: 11/26/2024

NARRATIVE

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During interviews with the staff, four (4) out of four (4) did not corroborate the allegation. One of the staff interviewed stated that they always ensure that they have personal care items including hand soap and toilet paper available and in stock for the clients. Another staff member stated that they do the ordering for these items, and these items are ordered once every 2 weeks to ensure that the assigned cleaning staff member for the day checks every day to ensure that hand soap is stocked up any available for the clients, along with the toilet paper and toilet seat covers at the end of their shift every day. During a tour of the resident restrooms, LPA observed that toilet paper, hand soap, and toilet seat covers were in stock and available for the clients in the facility.

In regards to the allegation that "Staff are not addressing a resident's behavior," it is alleged that C2 has been threatening the clients and staff members at the facility, and that these issues have not yet been addressed by the licensee. During interviews with the clients, six (6) out of six (6) did not corroborate the allegation. One client interviewed stated that none of the other clients in the facility have been making threats towards others. Another client stated to their knowledge there are no physical threats being made by anyone in the facility towards others. During interviews with the staff, four (4) out of four (4) did not corroborate the allegation. One of the staff interviewed it is true that C2 has been threatening the staff members, however no threats have been made towards other clients and they are working with C2 to redirect them when their behaviors occur and to advise him not make any inappropriate comments. Another staff also stated that C2 has behaviors including making inappropriate comments towards clients and staff members, and stated that when this occurs they let C2 know that these comments are inappropriate and counsel C2 when necessary. During record review of C2's Behavior Data Sheet, LPA observed that there have been multiple instances of inappropriate social and sexual behavior for the month of November 2024 and that they are being tracked.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. 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 held, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024

LIC9099 (FAS) - (06/04)

Page: 6 of 6