198602891-10-31-2024-28-AS-RORN-DB8RCJ-20241121115425

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602891
Report Date: 10/31/2024
Date Signed: 10/31/2024 12:00:41 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
06/17/2024 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240617092440

FACILITY NAME:	ELWYN CALIFORNIA - EL MONTE		FACILITY NUMBER:	198602891
ADMINISTRATOR:	ADALID SOLANO GUTIERREZ		FACILITY TYPE:	735
ADDRESS:	12052 CONFERENCE ST		TELEPHONE:	(626) 672-0248
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91732
CAPACITY:	4	CENSUS: 4	DATE:	10/31/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Hazel Gatan		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Unknown adult threw resident to the ground

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Staff Josephina Untalan and explained the reason for the visit.
The purpose of the visit is to deliver the findings for the above allegation.
The initial visit was conducted on 06/18/2024 and the following occurred:
Resident and Staff Roster and Special Incident Report (SIR) were submitted.
Interview was conducted with the Administrator telephonically at 2:00 PM.
Interview was conducted with Staff S1-S3 from 2:30 PM to 3:30 PM.
In regards to the allegation Unknown adult threw resident to the ground, based on interviews conducted and information gathered it was revealed by the former Administrator that based on his investigation and judgement that Staff S1 didn't abuse Client C1. Stated that the allegation was alleging abuse from over 2 years ago. Said that there had never been any complaints and Regional Center never had any issues.
Interview with Staff S2 who stated that she has never observed Staff S1 being aggressive to the clients and that there are always staff here and they would have seen or heard about it occurring.

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: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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 28-AS-20240617092440

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: ELWYN CALIFORNIA - EL MONTE	FACILITY NUMBER: 198602891
	VISIT DATE: 10/31/2024

NARRATIVE

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Said that Staff S1 was not a risk to client's in care.
Interview was conducted with House Manager Staff S3 who stated that he had received a call from a staff member who stated that Staff S1 is not nice to Client C1 and also stated that Staff S1 was physically abusive to Client C1.
Stated he had not observed Staff S1 ever physically abusive to any clients.
Said that there is always a 1 on 1 for Client C2 so there is always that staff plus other 1 on 1's for every shift.
Stated the alleged incident was alleged to have occurred in 2022. Had never at any time had to do a Special Incident Report (SIR) for Client C1 in regards to bruises or injuries related to physical abuse.
Also stated that Client C1's family is very involved and they have never voiced any complaints.
Attempts were made to contact Staff S1 were unsuccessful on 06/20/2024, 09/13/2024 and 10/30/2024.
Staff S1 no longer works at this facility.
Attempts were unsuccessful to interview Client 1 who is non verbal and unable to respond to questioning.
It should also be noted that the Regional Center completed an investigation and the results were Unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC9099 (FAS) - (06/04)

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