198602023-6-9-2022-28-AS-SCOL-CFSUB8-20220627152554

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602023
Report Date: 06/09/2022
Date Signed: 06/09/2022 03:50:35 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
05/26/2022 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220526142832

FACILITY NAME:	CASA FATIMA		FACILITY NUMBER:	198602023
ADMINISTRATOR:	YUSIMI F. TRAVIESO		FACILITY TYPE:	735
ADDRESS:	4016 EAST 61ST STREET		TELEPHONE:	(562) 682-9667
CITY:	HUNTINGTON PARK	STATE: CA	ZIP CODE:	90255
CAPACITY:	4	CENSUS: 4	DATE:	06/09/2022
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Claudia Lujan		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff is under the influence of marijuana while providing care and supervision
Staff was abusive towards Client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Claudia Lujan and explained the reason for the visit.
The purpose of the visit is to deliver the findings from the original complaint dated 05/26/2022.
Initial visit was conducted on 06/02/2022 and the following occurred:
Interviews were conducted from 2:00 PM to 2:20 PM with Administrator Claudia Lujan.
Staff S1, S2 and Clients C3 and C4 were interviewed from 2:20 PM to 3:00 PM.
Attempts were made to interview Client C 1 and C2 who didn't respond to questioning and are non-verbal.
In regards to the allegation Staff is under the influence of marijuana while providing care and supervision, based on interviews conducted and information gathered client's stated that they had never observed anyone smoking marijuana at the facility and had not smelled marijuana and that staff are kind.
Staff interviewed who had worked on the weekend stated that they had not seen anyone smoking marijuana .Staff said they had not heard or seen of anything bad at the facility. Stated they had not smelled marijuana at the facility.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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-20220526142832

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: CASA FATIMA	FACILITY NUMBER: 198602023
	VISIT DATE: 06/09/2022

NARRATIVE

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It should be noted that the investigation by the representative for SCLA Regional Center conducted on 05/25/2022 and 05/26/2022 resulted in Inconclusive findings.

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.

In regards to the allegation Staff was abusive towards Client, based on interviews conducted and information gathered client's interviewed stated that staff are kind and nice and stated that staff never pushed anyone and had done nothing physical to anyone Stated that Staff S1 has never been mean to Client C1 and has not pushed or been physical with C1.
Said that S1 helps C1 with his meals, meds and showers.
Stated that S1 has not thrown away C1's food.
Staff interviewed stated that C1 will be a picky eater and will not let anyone touch his food. Stated that he throws his leftovers in the trash and doesn't let anyone touch it. 1 staff who has been there 5 years said nothing strange happened. S 1 showers and feeds them and reports anything to Administrator.
Stated she hasn't seen pushing or grabbing of C 1.
Another staff who does 1 on 1 with C1 stated she has never seen him hit or yelled at.
Stated that every time she comes to her shift C1 is fine .There are no bruises.
She has never seen S 1 throw C 1's food away. She saw her cook for him and other clients on the weekend.
Said C1 might not want to eat so S 1 puts it into microwave and he gets it later.
Stated she has been there 6 years and never seen C 1 harmed.
Another staff interviewed stated S 1 is good with C1. Takes care of him good. Doesn't throw his food in garbage and has not hit him or pushed him. She works with S1 and she helps C1 with showering.
All staff interviewed had not seen or heard of S1 being abusive to C1.
It should be noted that the investigation by the representative for SCLA Regional Center conducted on 05/25/2022 and 05/26/2022 resulted in Inconclusive findings.

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.

Exit interview conducted with Administrator.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC9099 (FAS) - (06/04)

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