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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601952
Report Date: 04/18/2024
Date Signed: 04/18/2024 09:33:03 AM

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
01/02/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240102145559
FACILITY NAME:TOPAZ GEM HOME CAREFACILITY NUMBER:
198601952
ADMINISTRATOR:TORRES, GALILEOFACILITY TYPE:
735
ADDRESS:2996 ABBOTT STTELEPHONE:
(909) 908-8128
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY:6CENSUS: 6DATE:
04/18/2024
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Jose GoingoTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Personal Rights/Facility staff inappropriately touched a client in their private area.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra and Christian Gutierrez conducted a subsequent visit for the above allegation. LPA met with Jose Goingo and discussed the purpose of today’s visit.

On 01/03/24, Licensing Program Analyst (LPA) Elizabeth Irra conducted an initial 10-day complaint visit. LPA met with Jose Goingo and discussed the purpose the visit. LPA conducted a tour of the building and grounds and did not observe any signs of neglect, abuse or other immediate health and safety threats. During this visit, LPA reviewed Client #1 (C-1), Client #2 (C-2) and Staff #1 (S-1) files and obtained relevant documentation. Additionally, LPA obtained a copy of the staff roster with contact telephone numbers and a copy of the client roster. This investigation was also assigned to the Investigation Branch (IB) Investigator, Peter Zertuche.

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

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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 2
Control Number 28-AS-20240102145559
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: TOPAZ GEM HOME CARE
FACILITY NUMBER: 198601952
VISIT DATE: 04/18/2024
NARRATIVE
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Allegation: Personal Rights/Facility staff inappropriately touched a client in their private area. During this investigation, IB Investigator Zertuche conducted interviews with the C-1, C-2 and San Gabriel Pomona Regional Center. Per Investigator Zertuche, C-1 is non-verbal and was unable to be interviewed. Per Investigator Zertuche, C-2 did not have any concerns. IB Investigator Zertuche also followed up with Pomona Police Department and was informed that the case was not investigated and was not provided a reason. LPA interviewed C-3 through C-5 and S-1 through S-4. LPA was unable to interview C-6 as C-6 was not present at the time of the visits.

The investigation revealed the following: (4) out of (6) client interviews revealed that staff do not inappropriately touch clients. Client interviews revealed that there are (2) staff present and not just S-4. Interviewed clients indicated they have not been inappropriately touched by any staff. Interviewed clients indicated they have not heard of nor witnessed any staff (including S-1) inappropriately touching clients. Staff interviews revealed that staff do not inappropriately touch clients. Interviewed staff indicated there are (2) staff present and that S-1 is not left alone with clients. Interviewed staff indicated they have not received any complaints nor concerns in regards to this matter. Interviewed staff indicated they are trained in mandated reporting, zero tolerance and client rights. Client and staff interviews do not corroborate this allegation.

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



Exit interview was conducted and a copy of this report and appeal rights were provided to Jose Goingo.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2