198601942-11-7-2023-28-AS-RORN-CXRNVW-20231120094838

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601942
Report Date: 11/07/2023
Date Signed: 11/07/2023 01:19:33 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
10/05/2021 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20211005101814

FACILITY NAME:	INCLUSION SPECIALIZED PROGRAMS LLC - AGRA		FACILITY NUMBER:	198601942
ADMINISTRATOR:	KELLY HITCHENS		FACILITY TYPE:	735
ADDRESS:	5528 AGRA ST		TELEPHONE:	(562) 447-0991
CITY:	BELL GARDENS	STATE: CA	ZIP CODE:	90201
CAPACITY:	4	CENSUS: 3	DATE:	11/07/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Louneesha Young, House Manager		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Client's needs are not being met while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint investigation for the allegation listed above. LPA met with the house manager, Louneesha Young and explained the purpose of the visit. The administrator, Raymundo Lopez, arrived shortly thereafter.

The investigation consisted of the following:
On 10/7/21, LPA G. Trueman and L. Mora conducted an initial visit and gathered documents. LPAs also interviewed the Residential Director, 2 Staff, and a Client. During the visit today, LPA Chan interviewed the administrator, 4 Staff, and 3 Clients. LPA reviewed and obtained documents for Client #1’s.

The investigation revealed the following:
Allegation – Client’s needs are not being met while in care. It was alleged that Client #1 (C-1) was seen with both legs swollen, neck flexion, and decline in physical appearance back in September 2021.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

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 28-AS-20211005101814

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: INCLUSION SPECIALIZED PROGRAMS LLC - AGRA	FACILITY NUMBER: 198601942
	VISIT DATE: 11/07/2023

NARRATIVE

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LPA interviewed the administrator and staff. They stated doctor appointments are scheduled for all the clients to see the primary, orthopedic, dentist, and vision. However, they stated C-1 would sometimes refuse to go and would need to reschedule for another date. They stated doctors are aware of C-1’s condition and has been monitoring client throughout the years. They stated that C-1 has edema which causes the feet to swell. C-1 does not like to wear compression socks or elevate the legs to reduce the swelling. They also noted C-1 does not make healthy food choices and likes to drink soda. Staff indicated they serve meals with meats, fruits, and vegetables, and encourage client to eat more. They are aware of C-1’s behaviors and try to encourage or prompt client often.

LPA reviewed C-1’s file which showed that C-1 had gone to medical appointments annually and when needed for medical concerns. In addition, staff documented when C-1 refused to attend the appointments as well. Clients interviewed stated staff assist with their needs. They arrange for their medical appointments and cook for them or assist with their cooking.

Based on information gathered, there is no indication of staff neglecting the needs of clients at the facility.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted with Louneesha Young. A copy of this report along with the appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2023

LIC9099 (FAS) - (06/04)

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