198602544-9-21-2022-28-AS-MVAO-CLVTHR-20221207134511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602544
Report Date: 09/21/2022
Date Signed: 09/21/2022 02:20:00 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
08/15/2022 and conducted by Evaluator Christine Wong

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220815111123

FACILITY NAME:	PEOPLE'S CARE FERRERO		FACILITY NUMBER:	198602544
ADMINISTRATOR:	AARON EATON		FACILITY TYPE:	735
ADDRESS:	431 FERRERO LN		TELEPHONE:	(909) 287-3557
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	4	CENSUS: 3	DATE:	09/21/2022
		UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Aaron Eaton-Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff are physically restraining residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Wong conducted a subsequent complaint visit to investigate the above allegation. LPA met with DSP Lizsandra Magana and explained the reason of the visit and shortly after, LPA with the administrator Aaron Eaton and assisted with the visit.

The investigation consisted of the following: On 8/23/22, LPA interviewed administrator, three staff (S1-S3) and three clients (C1-C3). LPA also obtained the documents including C4's incident report dated on 6/21/22, 7/1/22 and 7/5/22 and C1's incident report dated on 7/23/22 , copy of staff CPI card and recent staff CPI training log and topic.

The investigation revealed of the following: In regard to the allegation of “Staff are physically restraining residents in care”, it was alleged the staff members are physically restraining the residents.
(See LIC 9099C for continuation)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

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 28-AS-20220815111123

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: PEOPLE'S CARE FERRERO	FACILITY NUMBER: 198602544
	VISIT DATE: 09/21/2022

NARRATIVE

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LPA interviewed clients and reported staff used the physical restraint/CPI to calm down the clients as sometimes client was endangered to self and others. The staff was never being rough on them or touched or hurt them. LPA interviewed staff and stated that the home is a behavioral home and they can use CPI/physical restraint on clients if clients were endangered to self or others, but the CPI techniques should always use as the last resort. LPA reviewed the incident report, the staff used CPI/physical restraint twice in the month of June and twice in the month of July and there were no CPI involved in the month of August. Therefore, it indicated the staff was not constantly physically restraining the clients.

Based on the interviews conducted with staff and clients and record reviewed, 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 complaint investigation of the allegation is unsubstantiated.

An exit Interview was conducted, and a copy of the report and appeal right was provided to Administrator Aaron Eaton.

NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

LIC9099 (FAS) - (06/04)

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