<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602573
Report Date: 06/17/2022
Date Signed: 06/20/2022 07:06:03 AM

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 DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/08/2022 and conducted by Evaluator Susan Campos
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20220608130414
FACILITY NAME:TRINITY HOMESFACILITY NUMBER:
198602573
ADMINISTRATOR:AYOARIYO, GEORGEFACILITY TYPE:
735
ADDRESS:17505 HARWICK CTTELEPHONE:
(310) 753-3777
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY:4CENSUS: 0DATE:
06/17/2022
UNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:George AyoariyoTIME COMPLETED:
02:01 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is unkempt and in disrepair
Facility did not make hazardous items inaccessible to clients in care
Facility has bed bugs
Facility has expired food
Facility made building alterations without notifying CCL
Facility is not affording clients the right to privacy
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/17/2022 at 9:08 am, Licensing Program Analyst (LPA)/Susan Campos, conducted a subsequent complaint investigation visit for the allegations listed above. The LPA was allowed entry into the facility by George Ayoariyo, Administrator. LPA explained to Mr. Ayoariyo the purpose of the visit. There are currently no clients living in the facility. The investigation consisted of the following: LPA conducted interviews with (2) staff member on 6/16/22. In addition, on 6/16/22, LPA and Mr. Ayoariyo conducted an inspection, for health and safety of the facilities’ physical plant, and food supply. The LPA also reviewed the following documents provided by Mr. Ayoariyo, Administrator: Staff roster, House Rules, and Repair Receipts.

Complaint Investigation Report continued on LIC 9099C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Susan Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
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 4
Control Number 11-AS-20220608130414
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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: TRINITY HOMES
FACILITY NUMBER: 198602573
VISIT DATE: 06/17/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
there are bed bugs in the facility. The LPA interviewed (2) Trinity Home staff personnel, and 2 of 2 staff personnel informed the LPA, that there are no bed bags in the facility. The LPA toured the facility with S1, and the LPA did not observe bed bugs in the clients bedrooms or in other areas inside the facility.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Facility has bed bugs”

Allegation: Facility has expired food

The investigation revealed, per LPA interviews, with (2) staff members, from the Trinity Home facility, and also review of facility documents, that the facility does not have expired food. S1 informed the LPA, that there are no expired food items in the facility. S1 also stated, that the staff purchase facility food often. Also, S1 informed the LPA that S1 had not received reports from staff or clients that there had been expired food in the facility. The LPA interviewed (2) Trinity Home staff personnel, and 2 of 2 staff personnel interviewed, informed the LPA, that they have not seen expired food in the facility. The LPA and S1 toured the facility, and the LPA did not observe expired food in the kitchen pantry cabinet, refrigerator or freezer. The LPA observed that the food supply is in compliance with title 22 required 3-day perishable, and 7-day non-perishable food supply.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Facility has expired food”

Allegation: Facility made building alterations without notifying CCL

The investigation revealed, per LPA interviews, with (2) staff members, from the Trinity Home facility, and also review of facility documents, that the facility has not made building alterations without notifying CCL. In addition, S1 informed the LPA, that the facility does not have building alterations taking place in the facility. S1 also stated, that the facility has no alterations being conducted. The LPA interviewed (2) Trinity Home staff personnel, and 2 of 2 staff personnel, informed the LPA, that there are no building alterations being conducted in the facility. The LPA and S1 toured the facility, and the LPA did not observe building alterations inside or outside of the facility property grounds.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Facility made building alterations without notifying CCL ”

Report continued on LIC 9099C

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Susan Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20220608130414
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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: TRINITY HOMES
FACILITY NUMBER: 198602573
VISIT DATE: 06/17/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Investigation

Allegation: Facility is unkempt and in disrepair

The investigation revealed, per LPA interviews, with (2) staff members, from the Trinity Home facility, and also review of facility documents that the facility is clean and not in disrepair. S1 informed the LPA, that the facility is clean and disinfected throughout the day. S1 also stated, that there are staff procedures for beginning and end work shift duties to clean the facility, and also to make sure everything is in place. Also, S1 informed the LPA, that there are no repairs being conducted in the facility, and that the facility is not in disrepair. The LPA interviewed (2) Trinity Home staff personnel, and 2 of 2 staff personnel, informed the LPA, that the facility is cleaned daily, and that the facility does not have any repairs being conducted. The LPA toured the facility with S1, and did not observe the facility unkempt, and also the LPA did not observe the facility in disrepair.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Facility is unkempt and in disrepair”

Allegation: Facility did not make hazardous items inaccessible to clients in care

The investigation revealed, per LPA interviews, with (2) staff members, from the Trinity Home facility, and also review of facility documents that the facility did not have hazardous items accessible to clients in care. In addition, S1 informed the LPA, that all facility hazardous items are stored in a locked garage cabinet. S1 also stated, that the staff are trained and reminded that all hazardous items, and chemical liquids are always kept in a locked cabinet in the garage. The LPA interviewed (2) Trinity Home staff personnel, and 2 of 2 staff personnel, informed the LPA, that all staff keep the facility cleaning and disinfectant products in a locked garage cabinet. The LPA and S1 toured the facility, and observed that all facility hazardous products, and cleaning chemicals are located in a locked cabinet in the facility garage.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Facility did not make hazardous items inaccessible to clients in care”

Allegation: Facility has bed bugs

The investigation revealed, per LPA interviews, with (2) staff members, from the Trinity Home facility, and also review of facility documents that the facility does not have bed bugs in the facility. S1 informed the LPA, that there are no bed bugs in the facility. S1 also stated, that has not received reports from staff or clients that

Report continued on LIC 9099C

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Susan Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20220608130414
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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: TRINITY HOMES
FACILITY NUMBER: 198602573
VISIT DATE: 06/17/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Facility is not affording clients the right to privacy

The investigation revealed, per LPA interviews, with (2) staff members, from the Trinity Home facility, and also review of facility documents that the facility provides it's clients with the right to privacy. S1 informed the LPA, that all clients that live in the facility have their own bedroom, and clients go into their bedroom when they want personal privacy. In addition, S1 stated that all cameras, in the facility, are stationed only in common areas, and are not pointed towards clients bedrooms. The LPA interviewed (2) Trinity Home staff personnel, and 2 of 2 staff personnel informed, the LPA, that the facility clients have privacy in their room, and that they close their door when they want to be alone, and also 2 of 2 staff personnel informed the LPA, that there are no facility cameras pointed towards the clients bedrooms. The LPA and S1 toured the facility, and the LPA observed that there is only one bed, in each client bedroom, and that each client bedroom has a door, and also the LPA observed, that all facility cameras are stationed and pointed only to facility common areas. In addition, the LPA also observed that facility cameras are not stationed or pointed towards clients bedrooms.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Facility is not affording clients the right to privacy ”

The LPA did not interview Trinity Homes facility clients for complaint investigation, because there are currently no clients living in the facility.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated. An exit interview was conducted with George Ayoariyo and a hard copy of a LIC 9099 was provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Susan Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4