<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601740
Report Date: 03/17/2022
Date Signed: 03/17/2022 02:15:43 PM

Unsubstantiated


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
03/10/2022 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220310155058
FACILITY NAME:QUALITY OF LIFE ACADEMYFACILITY NUMBER:
198601740
ADMINISTRATOR:NNAEMEKA EZENAGUFACILITY TYPE:
775
ADDRESS:8439 CALIFORNIA AVENUETELEPHONE:
(562) 372-4750
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY:66CENSUS: 31DATE:
03/17/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:S-1TIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility restrooms inoperable.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Elizabeth Irra conducted the initial 10-day unannounced complaint visit to investigate the above allegation. LPA met with S-1 and discussed the purpose of today's visit.

During today's visit, LPA obtained Client Roster, Staff Roster, LPA interviewed Staff #1, Staff #2 and Staff #3 (S-1 through S-3) and Client #1 and Client #3 (C-1 through C-3). LPA also conducted a facility tour for both buildings. Restrooms were inspected.

Refer to LIC 9099C for the continuation of this report.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
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-20220310155058
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: QUALITY OF LIFE ACADEMY
FACILITY NUMBER: 198601740
VISIT DATE: 03/17/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Facility restrooms inoperable. During this investigation, LPA interviewed Staff #1 through Staff #3 and Client#1 through Client #3. LPA also conducted a tour of both buildings. The front building has (1) client restroom and the back building has (1) client restroom and (1) staff restroom. Staff interviews revealed that on 02/23/22 the staff restroom in the back building was "backed-up" at approximately 1 P.M. Per S-1, plumbing items were purchased the same day for the repair (receipt of purchased was obtained). During this repair, staff utilized the clients restrooms. Per staff interviews, the Client restrooms have been operational and have not required any repairs. Client interviews revealed that Client restrooms have been operational. Interviews conducted, facility tour and documentation reviewed do not corroborate this allegation.

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, a copy of this report and Appeal Rights were provided to S-1

NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2