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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602585
Report Date: 08/27/2024
Date Signed: 08/27/2024 12:17:05 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
08/21/2024 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240821150309
FACILITY NAME:CENTER FOR BEHAVIORAL CHANGE #5FACILITY NUMBER:
198602585
ADMINISTRATOR:LATONYA KINGFACILITY TYPE:
735
ADDRESS:2111 EAST GARVEY AVE NORTHTELEPHONE:
(626) 502-1424
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:4CENSUS: 4DATE:
08/27/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Latonya KingTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff are not allowing resident to eat
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman conducted a complaint investigation on the allegation 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 and # 2, and Clients #1 - #4 .
The investigation revealed the following:
Allegation - Staff are not allowing resident to eat, LPA interviewed the administrator, staff, and clients. Administrator and staff stated that clients can eat whatever they want. They refill the cabinet every Monday with different snacks and clients have access to them anytime. Staff stated that a recent incident involved Client #1 eating 2 to 3 bowls of cereal at 3 PM and then wanting dinner right after that. Staff was trying to monitor the eating habit and explained that it is for the other clients as well and dinner will be at 4 PM.
Also stated that Client #1 will eat non-stop and throw up afterwards and they have put staff and clients
names on food, but Client #1 will still eat that too. Clients still had access to other snacks and/or when they
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
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-20240821150309
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: 08/27/2024
NARRATIVE
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 request for them.
During the visit today. LPA observed the food supply which had a surplus of meats, vegetable and fruits.
In the garage was a surplus supply of perishables and non- perishables.
Interviews with Clients #2- #4 who all stated that Client # 1 will finish everything and they won't have for others and just have snacks in between.
Also stated that there was an incident where Client # 1 finished all the corn and cheese and also ate all the cookies.
Stated Client #1 does not care and will leave little for others.

Although the allegation 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.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2