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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602378
Report Date: 07/13/2022
Date Signed: 07/13/2022 12:41:14 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
07/05/2022 and conducted by Evaluator Elizabeth Irra
COMPLAINT CONTROL NUMBER: 28-AS-20220705111412
FACILITY NAME:RHEMA CARE GROUP LLC IIIFACILITY NUMBER:
198602378
ADMINISTRATOR:NWAKA, KALUFACILITY TYPE:
735
ADDRESS:1999 WRIGHT STREETTELEPHONE:
(818) 824-0340
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:4CENSUS: 3DATE:
07/13/2022
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Staff #1 (S-1)/AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff do not prevent a client from wandering while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an initial complaint visit to investigate the above allegation. LPA met with Staff #1 (S-1) and explained the purpose of today's visit.

During today's visit, LPA obtained a copy of the staff roster and client roster. LPA reviewed Client #1's (C-1) file and obtained relevant documentation. LPA also interviewed C-1, Staff #1 through Staff #4 (S-1 through S-4) and Placement Agency Service Coordinator.

Refer to LIC 9099C for the continuation of this report.





Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
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-20220705111412
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: RHEMA CARE GROUP LLC III
FACILITY NUMBER: 198602378
VISIT DATE: 07/13/2022
NARRATIVE
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Allegation: Staff do not prevent a client from wandering while in care. During this investigation, LPA reviewed C-1's file and conducted interviews with C-1, Staff #1 through Staff #4 (S-1 through S-4) and Placement Agency Service Coordinator. Staff interviews along with the Service Coordinator interviews revealed C-1 has a history of AWOL. Interviews revealed that when C-1 attempts to AWOL, staff verbally redirect C-1 and when not successful (as C-1 may become physically aggressive), C-1 leaves the facility and staff follow C-1 on a distance to avoid C-1 from becoming physically aggressive. Per interviews, C-1 has a history of wanting to call 911 to be taken to the Emergency Room or 51/50 for no reason. Per S-1 interview, due to C-1's history of AWOL and increase in behaviors, S-1 met with Placement Agency and have discussed relocation to a higher level of care facility. The proposed new relocation has a gated yard to prevent C-1 from going to neighbors requesting to call 911. C-1's relocation is currently pending. Interviews and documentation reviewed do not corroborate this allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated

Exit interview conducted, Appeals Rights and a copy of this report was provided to S-1.
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC9099 (FAS) - (06/04)
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