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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602077
Report Date: 07/25/2023
Date Signed: 07/25/2023 03:29:42 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
05/15/2023 and conducted by Evaluator Ernand Dabuet
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20230515130137
FACILITY NAME:LIVING WELL 2FACILITY NUMBER:
198602077
ADMINISTRATOR:HOWELL, KARONFACILITY TYPE:
735
ADDRESS:434 W. SCHOOL STREETTELEPHONE:
(424) 296-5408
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY:4CENSUS: 3DATE:
07/25/2023
UNANNOUNCEDTIME BEGAN:
01:23 PM
MET WITH:Koron HowellTIME COMPLETED:
02:44 PM
ALLEGATION(S):
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Staff left clients unattended while in care.
Staff hit a client with an object while in care.
Staff allowed a client to hit another client while in care.
Staff offered a client to smoke marijuana while in care.
Staff yelled at a client.
Staff retaliated against a client.
INVESTIGATION FINDINGS:
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On 07/25/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted an office complaint visit. LPA met with administrator Koron Howell at El Segundo Community Care Licensing office at 1000 Corporate Center Drive, Monterey Park, CA 91754. LPA explained the purpose of the office meeting is to deliver the findings for the allegations mentioned above.

The investigation consisted of the following: A review of client roster, staff roster, service records for client
#1-#4 (C1-C4), and other pertinent documents associated with this complaint. An interview with Staff #1-#4 (S1-S4), Client #1-#4 (C1-C4) and Witnesses #1-#7 (W1-W7). A tour of the facility was conducted. A collateral visit at Bailey's Place Adult community Center.

(Evaluation Report continues LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023
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 4
Control Number 11-AS-20230515130137
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: LIVING WELL 2
FACILITY NUMBER: 198602077
VISIT DATE: 07/25/2023
NARRATIVE
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INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Staff left clients unattended while in care.

The details of the complaint alleged staff had left client #1 (C1) and other clients unattended while out on a community outing. The complainant stated during a community outing (C1) was left alone along with clients #2-#4 (C2-C4) were left in the van on 05/14/23 while the staff went inside a supermarket. Later during that same day, (C1) was left unsupervised on the beach while staff stayed in the var.

The Department interviewed (C1) who does not recall this incident. (C1) does not recall being left unattended by staff #1-#2 (S1-S2). (C1) recalls the outing on 05/14/23, but stated a staff was available during the entire outing while being out in the community. Interviews with (S1-S2) stated there is no validity to this accusation. (S1-S2) reported the clients are never left unsupervised for any reason. Interviews with South Central Los Angeles Regional Center (SCLARC) service coordinators witnesses #3-#5 (W3-W5) reported this group home has no history of concerns for lack of supervision. In a separate investigation, the Quality Assurance Specialist (SCLARC) found on the lack of supervision is not supported. From the information gathered, the Department has not found evidence supporting the above claim.

Allegation: Staff hit a client with an object while in care.


Staff allowed a client to hit another client while in care.

It is alleged that staff #1 (S1) had hit client #2 (C2) and (S1) allowed an individual hit (C2) while in care. According to the complainant, during an outing on 05/14/23, while in the van, (S1) had struck (C2) with a shoe across the face and arm for touching one of (S1's) personal items. (S1) also had allowed another individual hit (C2) in the van.

The Department interviewed client #1 (C1), who recalled the incident on 05/14/23 while in the van (C2) had touched one of (S1’s) personal items and was struck by (S1) with a shoe. (C1) stated staff #2 (S2) in charge of driving the van allowed this unacceptable behavior. (C1) reported that (C2) was also hit by another client hit (C2) and did nothing about it and allowed it to happen. (C1) did not have the name of the client.

(Evaluation Report continues LIC 9099-C)
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20230515130137
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: LIVING WELL 2
FACILITY NUMBER: 198602077
VISIT DATE: 07/25/2023
NARRATIVE
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Interviews with staff #1-#2 (S1-S2) claimed these accusations are not accurate. (S1-S2) acknowledge that there was an incident that occurred with (C2) as the victim of assault. However, the preparator (C1) was involved in the incident and was not an innocent bystander. (C2) while in the van with (C1) was upset with (C2) and had eaten a candy that belong to (C1). (S1) described while sitting in the passenger seat and (S2) was driving the van, (S1) heard a sound like someone was hitting someone. (S1) immediately intervene between (C1) and (C2) and sat in between them. (S1-S2) observed (C1) hit (C2). No other clients were hitting on (C2) as reported by (C1). Only (C1) did the hitting on (C2) and the staff immediately intervene. (S1-S2) immediately reported the incident to the administrator staff #4 (S4).

(S4) did an investigation of the incident and questioned (C1). (C1) admitted to being upset at (C2) for eating her candy and was upset with (S1) for being redirected and (C1) admitted falsifying the story. The investigation was documented in (C1’s) progress notes and reported to (SCLARC) and Community Care Licensing (CCL), Adult Protective Services (APS).

Interviews with South Central Los Angeles Regional Center (SCLARC) service coordinators witnesses #3-#5 (W3-W5) reported having no concerns for the health or safety of their clients in the group and there has been no history of abuse or lack of supervision. A separate investigation by the Quality Assurance Specialist (SCLARC) found that physical abuse and failure to provide safety are not supported. As a result of the information the Department has gathered, it has no evidence to support the allegations mentioned above.

Allegation: Staff offered a client to smoke marijuana while in care.

It is alleged that client #1 (C1) was offered by staff #3 (S3) to smoke marijuana while being cared for at this group home as reported by the complainant.

The Department interviewed (C1) who claimed no staff had offered (C1) legal or illegal drugs. (C1) stated (S3) did not offer cannabis to (C1). (C1) reported that staff #1 (S1) smokes cannabis during breaks while in a car parked in the driveway. An interview with (S1) denied this accusation. (S1) admitted not being a smoker of cigarettes or cannabis. Interviews with staff #2-#4 (S2-S4) refuted this claim. (S2-S4) stated none of the staff were smokers of cigarettes, marijuana, or anything else involving smoking.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20230515130137
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: LIVING WELL 2
FACILITY NUMBER: 198602077
VISIT DATE: 07/25/2023
NARRATIVE
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Interviews with South Central Los Angeles Regional Center (SCLARC) service coordinators witnesses #3-#5 (W3-W5) reported have not observed any of the staff members smoking on their inspection visits and there have been no concerns or issues regarding this matter brought to their attention. Interviews with adjacent neighbors witness #6-#7 (W6-W7) reported they have not witnessed any outdoor smoking activities. In a separate investigation, the Quality Assurance Specialist (SCLARC) determined that this allegation has no merit. The Department has gathered no evidence to support the above allegation based on information gathered by them.

Allegation: Staff yelled at a client.


Staff retaliated against a client.

The details of the complaint alleged that staff # (S1) had yelled and retaliated against client #1 (C1). The complainant reported that (C1) had expressed concerns with another unknown staff about staff #1 (S1’s) behavior on 05/14/23 with another unknown staff and that (S1) yelled and accused (C1) a “liar”.

The Department interviewed (C1) who claimed no staff incited a hostile environment toward (C1). (C1) reported no staff had yelled at (C1) or had taken retaliation actions towards (C1). Interviews with staff #1- #4 (S1-S4) disputed this claim and stated no clients have been victims of a verbal abuse or hostile environment. Interviews with South Central Los Angeles Regional Center (SCLARC) service coordinators witnesses #3-#5 (W3-W5) reported having no concerns for the health or safety for their client’s care and supervision. Quality Assurance Specialist (SCLARC) conducted a separate investigation and found no evidence to support the allegations. Based on the information gathered by the Department, there is no evidence to corroborate the allegations mentioned above.

Interviews were not available with clients #2-#3 (C2-C3) as they were unable to hold a conversation as a result of their disability. (C4) was not available for an interview.

Based on information gathered, an inspection of the facility, observation, and interviews conducted, documents reviewed, the Department found no evidence to support the allegations mentioned above.

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 Unsubstantiated.



An exit interview conducted with Koron Howell and a copy of the report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4