198602113-8-5-2024-28-AS-JBAE-D7UVTL-20240805164319

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198602113
Report Date: 08/05/2024
Date Signed: 08/05/2024 04:43:22 PM

Document Has Been Signed on 08/05/2024 04:43 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME:	AMBITIONS - HEDDA STREET		FACILITY NUMBER:	198602113
ADMINISTRATOR/ DIRECTOR:	LAQUALA MCKINLEY		FACILITY TYPE:	735
ADDRESS:	12914 HEDDA STREET		TELEPHONE:	(562) 474-8418
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY: 3		CENSUS: 3	DATE:	08/05/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Assistant Administrator Jassmond Johnson		TIME VISIT/ INSPECTION COMPLETED:	04:58 PM

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On 8/5/2024, Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced case management visit to follow up on the incident report and SOC 341 submitted by the Administrator Jassmond Johnson dated 7/2/2024, regarding a staff and client altercation. On 8/2/2024 the Assistant Administrator also called CCLD, and another SOC 341 was created for the incident. LPA met with Jassmond Johnson, Assistant Administrator and explained the reason for the visit.

During the visit, LPA interviewed the Assistant Administrator and a total of 2 staff (S1 and S2). Unfortunately, due to the limited communication skills of the clients, LPA was unable to interview the clients. 1 of the 3 clients is currently at the day program. A copy of the Staff roster, Client roster, CPI certification and S1 statement was obtained. This incident was also reported to law enforcement due to the nature of the incident and LPA is currently waiting on the results of their investigation.

According to SOC 341 and Incident report, it is alleged that on 7/31/2024, C1 exhibited aggressive behavior towards S1 by physically attacking S1. S1 then grabbed C1, and both fell to the ground, which caused bruises to C1. The second SOC 341, which was written when the Assistant Administrator called CCLD had a slight difference. The SOC 341 stated when C1 was attacking S1, S1 hit C1 back. S1 has since been suspended pending internal investigation.

The Assistant Administrator denied the second SOC341 stating during the called, it was never mentioned the S1 hit C1 back. According to the Assistant Administrator and S1 the incident took place while S1 was sitting on the couch. C1 walked up to S1 and started hitting S1. S1 then proceeded to walk outside to get the other staff assistance but was unable to. S1 stated while outside, C1 followed and kept hitting S1. After S1 went back inside to get C1’s toys to distract them, C1 started hitting S1 in the head. S1 then grabbed C1’s hands and they both fell. When they got up C1 still attempted to be physically aggressive until S1 got C1’s toys to distract C1. During the altercation S1 stated they never hit C1.

Additional follow up may follow. Assistant Administrator Jassmond Johnson was advised, and a copy of this report was given.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Jewel Baptiste
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024

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

LIC809 (FAS) - (06/04)

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