198602585-8-13-2024-28-AS-TVAO-D8BUAS-20240820152512

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602585
Report Date: 08/13/2024
Date Signed: 08/13/2024 12:53:32 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
08/07/2024 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240807151629

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: 4	DATE:	08/13/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	LaTonya King, Administrator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not provide residents with adequate food service.
Staff do not ensure facility is adequately cleaned.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation on the allegations listed above. LPA arrived unannounced and met with Administrator, LaTonya King. The purpose of the visit was explained.

LPA toured the facility, reviewed documents, and conducted interviews. LPA interviewed the administrator, Staff #1 - #3, and Clients #1 - #3.

The investigation revealed the following:
Allegation - Staff do not provide residents with adequate food service. It is alleged that if clients finish their snacks, they have to wait a week before they get more. It is also alleged that staff do not make them breakfast.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024

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-20240807151629

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: CENTER FOR BEHAVIORAL CHANGE #5	FACILITY NUMBER: 198602585
	VISIT DATE: 08/13/2024

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

LPA interviewed the administrator, staff, and clients. Administrator and staff stated they do not deprive clients of their snacks. They refill the cabinet every Monday with different snacks and clients have access to them anytime. In addition, the snack cabinet is not locked. Staff stated that a recent incident involved a client eating all the cookies in a day. When staff brought out another bag, the same client attempted to eat it continuously, so they put it away. Staff was trying to monitor the eating habit and explained that it is for the other clients as well. Clients still had access to other snacks and/or when they request for them.
Staff stated not all the clients eat breakfast, but when they do, staff will make it for them. They stated sometimes clients will make their own breakfast. LPA interviewed 3 clients. 2 out of the 3 stated they have access to snacks anytime of the day and staff would make them breakfast if they wanted something different besides cereal. During the visit today, LPA reviewed the food supplies. LPA observed the refrigerators filled with meats, vegetables, and fruits. The snack cabinet was not locked and facility has extra snacks in storage.

Allegation - Staff do not ensure facility is adequately cleaned. It is alleged that the staff do not clean the house. The administrator and staff stated they clean during each shift. They sweep and mop the floor daily and ensure that the entire house is tidy. They indicated that the home is designed for the clients to be more independent and therefore, they would encourage them to keep their rooms clean. LPA interviewed 3 clients who stated they clean their own rooms and bathrooms, but the staff will clean the other areas of the home. During the tour, LPA observed the house to be clean and organized.

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.

An exit interview was conducted with the administrator. A copy of this report along with the appeal rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2