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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602378
Report Date: 08/04/2023
Date Signed: 08/04/2023 01:57:23 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
02/11/2022 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220211092119
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: 4DATE:
08/04/2023
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Imeh Etudoh/S-3TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Personal Rights: Staff choked client while in care.
Personal Rights: Staff pushed client while in care.
Personal Rights: Staff handled client in an inappropriate manner resulting in injuries.
Personal Rights: Lack of supervision resulting in client wandering away from facility.
Personal Rights: Client not accorded privacy.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to investigate the above allegation. LPA met with Imeh Etudoh/S-3 and discussed the purpose of today’s visit. The initial visit was conducted on 02/14/2022 by LPA Alberto Lopez.

During this investigation, LPA obtained copies of the client and staff rosters, reviewed file for Client #1 (C-1) and obtained relevant documentation. LPA interviewed Staff #1 through Staff #3 (S-1 through S-3). LPA was unable to interview S-4 as S-4 is no longer working at this facility. LPA obtained relevant staff training records. LPA also interviewed C-1 through C-3. LPA was unable to interview C-4 as C-4 was not home at the time of this visit. LPA also placed numerous calls to San Gabriel Pomona Regional Center and left messages to inquire if an investigation was conducted and LPA did not receive any returned calls.

Refer to LIC 9099C for the continuation of this report.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
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 3
Control Number 28-AS-20220211092119
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: RHEMA CARE GROUP LLC III
FACILITY NUMBER: 198602378
VISIT DATE: 08/04/2023
NARRATIVE
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Personal Rights: Staff choked client while in care. Per staff interviews, staff do not choke clients. Interviewed staff indicated they have not witnessed nor received any complaints/concerns in regards to staff “choking” clients. Interviewed staff indicated they are trained in Zero Tolerance, Mandated Reporting, Client Rights and Crisis Prevention Intervention (CPI). (3) out of (4) clients indicated they have not been “choked” by staff nor they have witnessed staff “choking” clients. Interviewed clients indicated they do not have any concerns. Interviews do not corroborate this allegation.

Personal Rights: Staff pushed client while in care. Per staff interviews, staff do not push clients. Interviewed staff indicated they have not witnessed nor received any complaints/concerns in regards to staff “pushing” clients. Interviewed staff indicated they are trained in Zero Tolerance, Mandated Reporting, Client Rights and Crisis Prevention Intervention (CPI). (3) out of (4) clients indicated they have not been “pushed” by staff nor they have witnessed staff “pushing” clients. Interviewed clients indicated they do not have any concerns. Interviews do not corroborate this allegation.

Personal Rights: Staff handled client in an inappropriate manner resulting in injuries. Per staff interviews, staff do not handle clients in an inappropriate manner resulting in injuries. Interviewed staff indicated they have not witnessed nor receive any complaints/concerns in regards to staff not handling clients appropriately. Per staff interviews, C-1 has a history of behaviors that are being monitored, tracked and reported to C-1’s behaviorist. C-1’s behaviors include AWOL/Wandering, Verbal Aggression, Self-Injurious Behavior, Physical Aggression, Fabricating Stories/Allegations, Food Misuse and Non-Compliance. Interviewed staff indicated they are trained in Zero Tolerance, Mandated Reporting, Client Rights and Crisis Prevention Intervention (CPI). (3) out of (4) clients indicated they have not been handled inappropriately by staff nor they have witnessed staff handling clients inappropriately. Interviewed clients indicated they do not have any concerns. Interviews and reviewed documentation do not corroborate this allegation.

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

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20220211092119
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: RHEMA CARE GROUP LLC III
FACILITY NUMBER: 198602378
VISIT DATE: 08/04/2023
NARRATIVE
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Personal Rights: Lack of supervision resulting in client wandering away from facility. Per staff interviews, C-1 has a history of AWOL/Wandering and this behavior is being monitored, tracked and reported to C-1’s behaviorist. Per staff interviews, when C-1 is upset, C-1 exhibits AWOL/Wandering behavior and when this occurs, staff attempt to re-direct and if unsuccessful, staff will follow C-1 from a distance and continue with re-direction. Staff interviews and reviewed documentation indicated that on 02/09/2022, C-1 became upset when S-1 asked for a receipt for a cell phone C-1 had recently purchased and C-1 became physically aggressive towards S-1 prior to leaving this facility. S-1 proceeded to follow C-1 from a distance. Per staff interviews, C-1 was not left unsupervised. Interviewed clients indicated staff provide supervision and that they do not have any concerns. Interviews and reviewed documentation do not corroborate this allegation.

Personal Rights: Client not accorded privacy. Per staff interviews, clients are accorded with privacy. Interviewed staff indicated they have not received any complaints/concerns in regards to clients not being accorded with privacy. Interviewed staff indicated they are trained in Zero Tolerance, Mandated Reporting, Client Rights and Crisis Prevention Intervention (CPI). (3) out of (4) clients indicated they are accorded with privacy. Interviewed clients indicated they do not have any concerns. Interviews do not corroborate this allegation.

Although the allegations 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 allegations are unsubstantiated.



Exit interview was conducted and a copy of this report and appeal rights were provided to Imeh Etudoh/S-3.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3