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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602585
Report Date: 08/25/2022
Date Signed: 08/25/2022 11:29:08 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 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
08/23/2022 and conducted by Evaluator Christine Wong
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220823171140
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:
08/25/2022
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Monica Martinez TIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Resident was sexually abused by staff.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Wong conducted an initial complaint visit to investigation the above allegation. LPA met with DSP Monica Martinez and explained the reason of the visit.

The investigation consisted of the following: On today's visit, LPA toured the facility with DSP Monica and observed that the facility is clean and in good repair. LPA also observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days. Restrooms, hand washing basins, toilets and bathtub/showers are operable. There are no immediate health and safety concerns. LPA also interviewed four clients (C1-C4) and three Staff (S1-S3) in the facility and administrator and three staff on the phone. LPA also reviewed C1's file and all staff files.

The investigation revealed of the following: Allegation "Resident was sexually abused by staff." LPA interviewed all clients and they all denied the allegation and reported staff never sexually abused them or touched them. (See LIC 9099 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: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022
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 2
Control Number 28-AS-20220823171140
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: 08/25/2022
NARRATIVE
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LPA also interviewed staff and they all denied the allegation and reported they never witnessed any staff sexually abused or touched the clients in the facility. C1 also reported all staff treated C1 good and no staff ever physically or sexually abused any clients in the facility and C1 also stated no staff ever raped any clients in the facility and denied the statement that C1 had ever made in the facility before. LPA also reviewed all staff files and they all received the training about Zero Tolerance Policy and Abuse.

Based on LPA's interviews conducted and record review, investigation revealed: 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 allegation is UNSUBSTANTIATED.

No Deficiencies cited under California Code of Regulations Title 22. Exit interview conducted, and a copy of report and appeal right was provided to DSP.Monica Martinez
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2