198602585-5-5-2023-28-AS-RORN-CRNSNW-20230509140213

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602585
Report Date: 05/05/2023
Date Signed: 05/05/2023 12:45:54 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
01/14/2022 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220114085540

FACILITY NAME:	CENTER FOR BEHAVIORAL CHANGE #5		FACILITY NUMBER:	198602585
ADMINISTRATOR:	LATONYA KING		FACILITY TYPE:	735
ADDRESS:	2111 EAST GARVEY AVE NORTH		TELEPHONE:	(626) 502-1424
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91791
CAPACITY:	4	CENSUS: 3	DATE:	05/05/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	LaTonya King		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Facility staff interacted with resident in a physically inappropriate manner
Facility is serving expired food
Staff are not allowing resident access to her finances
Staff denied resident the ability to receive visitors

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted another visit to issue the final results of the investigation. LPA met with Administrator, LaTonya King who allowed entry into the facility and assisted with today's visit. Resident #1 is no longer residing at the facility, therefore LPA conducted telephonic interview with resident #1.

Regarding the allegation that facility staff interacted with resident #1 in a physically inappropriate manner, the investigation consisted of : interviews with Administrator, Staff #1 and resident #1. Administrator and Staff #1 denied the allegation. They stated that staff #1 did not interact with resident #1 in a physically inappropriate manner. Resident #1 stated that staff #1 did push her, and was "egging her on". There were no other residents living at the facility at the time of the alleged incident, and no witnesses to the allegation. Regarding the allegation that the facility is serving expired food, the investigation consisted of: interviews with Administrator, Staff #1, and resident #1, and review of facility food supply. Administrator and staff #1 denied the allegation. They stated that resident #1 was given expired food from a friend, and it was not facility food that was expired.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

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 28-AS-20220114085540

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: CENTER FOR BEHAVIORAL CHANGE #5	FACILITY NUMBER: 198602585
	VISIT DATE: 05/05/2023

NARRATIVE

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Resident #1 stated that the facility was serving expired food, and stated she had pictures but has deleted them. LPA reviewed facility food supply, and did not observe any food that was expired.

Regarding the allegation that staff are not allowing resident access to her finances, the investigation consisted of : interviews with Administrator, Staff #1 and Resident #1. LPA also review resident #1's P & I records. Administrator and Staff #1 denied the allegation. They stated that resident #1 had a part time through the day program, and resident #1 would receive her check directly, or it would be given to staff. Administrator stated that resident #1's parents picked up resident #1's checks, and would cash them for resident #1. Administrator stated that the facility only handled resident #1's P & I funds, but did not handle any of resident #1's money from the day program job. LPA observed P & I log and observed that resident #1 was withdrawing funds on a regular basis.

Regarding the allegation that staff denied resident #1 the ability to receive visitors, the investigation consisted of : interviews with Administrator, Staff #1 and Resident #1. LPA also reviewed several special incident reports in resident #1's file. Administrator and staff #1 denied the allegation. They stated that resident #1 was able to receive visitors at the facility. Administrator and staff #1 stated that resident #1 would "meet" strangers on social media and would invite them to come to the facility. Administrator and Staff #1 stated that they did not prevent resident #1 from having visitors, however they were in contact with resident #1's parents whenever they observed that resident #1 was making potentially unsafe decisions. Resident #1 stated that the facility staff did deny her visitors.

Based on LPA's observations and interviews, investigation revealed: Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

No Deficiencies cited under California Code of Regulations Title 22. Exit interview conducted, and a copy of report was provided to Administrator, LaTonya King.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2023

LIC9099 (FAS) - (06/04)

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