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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602214
Report Date: 06/13/2024
Date Signed: 06/13/2024 09:51:57 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
05/28/2024 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240528092107
FACILITY NAME:CENTER FOR BEHAVIORAL CHANGE 7FACILITY NUMBER:
198602214
ADMINISTRATOR:EBENEZER AKINOLAFACILITY TYPE:
735
ADDRESS:772 COBRE CTTELEPHONE:
(909) 629-1715
CITY:POMONASTATE: CAZIP CODE:
91768
CAPACITY:5CENSUS: 4DATE:
06/13/2024
UNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Jane Amalu, StaffTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Staff engaged in a phycial altercation with client in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to deliver a finding for the above allegation. LPA met with Staff, Jane Amalu, and explained the purpose for the visit.

LPA Chan conducted the initial visit on 6/4/24 and obtained a copy of the staff roster, client roster, and documents pertaining to Client #1. LPA interviewed the administrator, Staff #1 - #5, and the San Gabriel/Pomona Regional Center personnel. During the visit today, LPA interviewed Clients #1 - #3.

For allegation, staff engaged in a physical altercation with a client in care. It is alleged that a staff punched Client #1 (C-1) in the face during an altercation. It was noted that Staff #1 (S-1) said something that triggered C-1, who launched past the therapist and toward the staff. S-1 stood up and pushed C-1 who then fell to the ground. It was also indicated that C-1 wanted to talk to S-1 and when C-1 walked to the staff, the staff made a fist and punched C-1 in the face.
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: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
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-20240528092107
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: CENTER FOR BEHAVIORAL CHANGE 7
FACILITY NUMBER: 198602214
VISIT DATE: 06/13/2024
NARRATIVE
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LPA interviewed the administrator, a witness, and 5 Staff. S-1 denied punching C-1. S-1 explained that C-1 unexpectedly charged at staff while sitting on the sofa. S-1 immediately tried to evade C-1 and pushed client off. The witness stated that he/she was trying to calm down C-1 and redirect the client before C-1 charged at the staff. The witness did not observe staff punching C-1. It was noted that as the client ran towards the staff, S-1 immediately got up to dodge the client and the client fell due to contact. It was stated the incident happened quickly and ended quickly in a matter of seconds. No bruises or marks were observed on the face except for a little redness. Staff on duty during the incident immediately went to the living room when they heard the commotion. Although they observed C-1 on the ground, they saw no injuries or marks on the client. Staff stated the redness on C-1’s face was always there. The administrator and police officer were contacted and arrived the same day after the incident.

Staff interviewed stated they have training on CPI and ProAct and do not use restraints on clients. They do not engage in any altercations with clients either. They will redirect a client when necessary to de-escalate any behaviors. Per the administrator interview, S-1 has no disciplinary actions or warnings for unprofessionalism.

LPA interviewed 3 Clients today. 2 of the 3 clients enjoy living at the facility and stated staff treat them nicely and do not get into arguments with clients.

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 Staff Jane Amalu. 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: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2