198602614-6-19-2024-11-AS-EMAZ-D7BSZC-20240719141855

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602614
Report Date: 06/19/2024
Date Signed: 06/19/2024 04:37:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 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
06/12/2024 and conducted by Evaluator Wendy Gibbs

COMPLAINT CONTROL NUMBER: 11-AS-20240612153755

FACILITY NAME:	PRIME OPTIONS CARE INC		FACILITY NUMBER:	198602614
ADMINISTRATOR:	NGUYEN, HAI		FACILITY TYPE:	735
ADDRESS:	2041 W 162ND ST		TELEPHONE:	(310) 678-6784
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90504
CAPACITY:	5	CENSUS: 4	DATE:	06/19/2024
		UNANNOUNCED	TIME BEGAN:	01:17 PM
MET WITH:	Hai Nguyen		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff are not keeping P&I at the facility with ledgers
Staff do not keep the resident/staff files at the facility

INVESTIGATION FINDINGS:

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On 06/19/24, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced complaint visit to the facility listed above. LPA met with Administrator, Hai Nguyen, and the purpose of today’s visit was explained. During the time of visit, there were two (2) Clients present.

During today’s visit, LPA toured the facility, interviewed Staff (S1-S3), and received and reviewed documents pertinent to the investigation. The documents include Staff Roster, Resident Roster, and P&I ledgers.

The investigation revealed the following:

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

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 11-AS-20240612153755

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: PRIME OPTIONS CARE INC	FACILITY NUMBER: 198602614
	VISIT DATE: 06/19/2024

NARRATIVE

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Allegation: Staff are not keeping P&I at the facility with ledgers

It is alleged the facility is not keeping P&I monies/ledger at the facility and staff drive to other houses to get it.

During the visit, LPA requested to see the P&I monies and ledger for all Clients residing in the facility. The Clients money and ledger was available upon request. LPA observed the money and ledgers secured in a locked cabinet, in a locked safe box, in a locked office. LPA reviewed the ledgers, receipts, and monies and did not observe any discrepancies in the records and amounts. During interviews with the Administrator, was asked if the P&I ledgers and monies are kept at the facility, S1 stated the Clients monies are kept secured at the home and the ledgers are secured and maintained at the office and brought to the home. During interviews with the Staff (S2-S3), were asked if Clients P&I ledger and money are kept at the facility, two (2) out of two (2) stated the P&I ledgers and money are kept in a secured locked box, in a locked cabinet, in the locked staff office. Additioanlly, Staff S2 and S3 stated there have been no issues with Clients getting their P&I upon request. During LPAs visit, LPA was unable to interview Clients.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Allegation: Staff do not keep the client/staff files at the facility

It is alleged the facility is not keeping client and staff files at the facility and staff drive to other houses to get it.

Continued On LIC9099-C

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240612153755

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: PRIME OPTIONS CARE INC	FACILITY NUMBER: 198602614
	VISIT DATE: 06/19/2024

NARRATIVE

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During the facility visit, LPA requested staff and client files to review. LPA observed Client files secured in a locked cabinet in the locked staff office. The Staff files were brought to the facility within 10 minutes. LPA reviewed both staff and resident file and observed they had the required documents
During interviews with the Administrator S1, was asked if staff and resident files are kept at the facility, S1 stated the resident files are kept at the facility and the staff files are kept at the office. Additionally, S1 stated the staff are associated at all nine (9) of the facilities and are willing to work at other facilities if needed, and if staff files are requested at the facility, they are able to easily deliver the files if needed. During interviews with the Staff (S2-S3), were asked if client and staff files are kept in the facility, two (2) out of two (2) stated client files are secured in a locked cabinet in the locked staff office and staff file are kept at the main office due to staff working at the different facilities. During LPAs visit, LPA was unable to interview clients.

During today’s visit, LPA did not observe or cite any deficiencies.

An exit interview was conducted with Administrator, Hai Nguyen, and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC9099 (FAS) - (06/04)

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