198602216-7-3-2023-11-AS-UCOL-CW3SWZ-20230927141511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602216
Report Date: 07/03/2023
Date Signed: 07/03/2023 02:48:19 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
06/29/2023 and conducted by Evaluator David Espana

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230629083657

FACILITY NAME:	FRANCESCA'S HOME		FACILITY NUMBER:	198602216
ADMINISTRATOR:	COELLO, BESSIE L		FACILITY TYPE:	740
ADDRESS:	20520 AVIS AVENUE		TELEPHONE:	(310) 292-8425
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	6	CENSUS: 6	DATE:	07/03/2023
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	COELLO, BESSIE L, ADMINISTRATOR		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff failed to provide a comfortable environment for residents.

INVESTIGATION FINDINGS:

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On 07/03/2023, at 8:00 AM Licensing Program Analyst (LPA) David España met with met with Bessie L. Coello, Administrator and Cynthia Campos, House Manager to conduct a complaint investigation to address the allegations listed above. LPA España met with Bessie L. Coello, Administrator and explained the purpose of this visit.

The investigation consisted of the following: LPA España conducted a tour of the facility grounds. LPA España interviewed staff, clients, witnesses, and reviewed records. LPA España requested and reviewed the following documents, client roster, and staff roster, LIC 601 - Identification and Emergency Information, LIC 602A - Physician's Report, LIC 627C - Consent For Emergency Medical Treatment, LIC 625 - Appraisal Needs and Services Plan, and LIC 603A - Resident Appraisal. The investigation revealed the following: Regarding the allegation “Staff failed to provide a comfortable environment for residents.”

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: David Espana	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

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 11-AS-20230629083657

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: FRANCESCA'S HOME	FACILITY NUMBER: 198602216
	VISIT DATE: 07/03/2023

NARRATIVE

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It’s being alleged the facility has not provided a comfortable environment for residents.

5 out of 6 residents interviewed disagreed with the allegation and denied having any issues that staff has failed to provide a comfortable environment for residents.

3 out of 3 staff denied the allegation, S1, S2, & S3 denied receiving uncomfortable environment for residents: Regarding the allegation “Staff failed to provide a comfortable environment for residents.”

Based on interviews conducted, record reviews and observation, the preponderance of evidence standard has not been met. 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 Cynthia Campos, House Manager and a copy of this report was provided.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: David Espana	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

LIC9099 (FAS) - (06/04)

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