198601776-10-29-2021-11-AS-AJKK-C9SR4P-20211217114151

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601776
Report Date: 10/29/2021
Date Signed: 10/29/2021 05:48:59 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 DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2021 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20211021163549

FACILITY NAME:	LONE STAR BOARD & CARE		FACILITY NUMBER:	198601776
ADMINISTRATOR:	OTIS ALEXANDER		FACILITY TYPE:	735
ADDRESS:	5140 CRENSHAW BLVD		TELEPHONE:	(562) 544-5170
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90043
CAPACITY:	35	CENSUS: 19	DATE:	10/29/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Direct Care Staff, Semaj “Leon” Floyd		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff slapped client.
Staff do not treat clients with dignity.

INVESTIGATION FINDINGS:

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On 10/29/2021 Licensing Program Analyst (LPA) Troy Agard initiated a complaint investigation at the above facility to address the following allegations. LPA Agard was met with Direct Care Staff, Semaj “Leon” Floyd and explained the purpose of the visit was to gather information.

The investigation consisted of the following: LPA Agard toured the facility, and conducted interviews with staff, and clients.

On 10/29/2021 LPA Agard delivered findings.

Regarding the allegation: Staff slapped client. It’s being alleged that a staff that is currently working at the facility slapped a client in care and is mean towards them. The investigation revealed the following: 5 of the 5 clients interviewed state either never being hit by a staff or witnessing a staff hit a client. C1-5 all
Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021

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

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20211021163549

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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: LONE STAR BOARD & CARE	FACILITY NUMBER: 198601776
	VISIT DATE: 10/29/2021

NARRATIVE

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state never being assaulted by staff. C1 states, “I’ve never been slapped.”. C2-5 all state they never witness a staff hit another client.

During interviews with staff 1-5 they all state not being aware of any staff slapping a client in care. S1 states C1 accused S5 of slapping them but it was determined that the event never happened. S1 states, “S5 has a great relationship with the facility clients.” S2-4 all state they have not observed any staff hitting a client.
Regarding the allegation: Staff do not treat clients with dignity. It’s being alleged that a staff is mean to clients in care. The investigation revealed the following: 5 of the 5 clients interviewed state they are treated with dignity and respect. C1 states having some “differences in the past with a staff that they can’t remember at this time.” C1 denied having any issues with S5 or any current facility staff. C2-5 all state not having any issues with the staff and all feel like they are treated with dignity and respect.

During interviews with staff 1-5 they all state the clients are treated with dignity and respect. S1 states, “Absolutely, I demand that of the team.” S5 states, “yes, we do. They are treated very well. Most of them don’t have family so we are there family. They are spoiled here.”

Based on interviews, there was not enough evidence to support the allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are deemed unsubstantiated.

No deficiencies cited, exit interview conducted, and a copy of the report was given to the facility representative.

SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021

LIC9099 (FAS) - (06/04)

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