198602891-11-21-2024-28-AS-RORN-DBTQW6-20241210113125

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602891
Report Date: 11/21/2024
Date Signed: 11/21/2024 03:11:21 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
11/12/2024 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241112094346

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:	11/21/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Staff Regina Borranian		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are overmedicating resident.
Staff handles resident in an inappropriate manner.
Staff yells at resident.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced subsequent visit to the facility and was greeted by Staff Regina Borranian and explained the reason for the visit.
The purpose of the visit is to deliver findings from the original complaint dated 11/22/24.

At today's visit Client C1 and Client C4 were interviewed.
The initial visit was conducted on 10/29/2024 and included the following: Interview was conducted with the Administrator and Staff S1 and S2.
Attempts were made to interview Client C1 were unsuccessful with C1 refusing to be interviewed.
Attempts were unsuccessful to interview Client's C2 and C3 who are non verbal and unable to respond to questioning.
Subsequent visit was conducted on 11/14/24 and included the following:
Interview was conducted with the Administrator and Staff S1- S3.
In regards to the allegation Staff are overmedicating resident, based on interviews conducted and

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: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

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-20241112094346

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: 11/21/2024

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

information gathered it was revealed in interview with Client C1 that she has never been given too much medication and always gets her meds and it's just right.
The MAR's log from 08/24-10/24 documents PRN medications that are initialed by staff that the medication was administered and given as needed.
Staff interviewed stated that Client C1 has many behaviors and staff will ask her to calm down or will take a walk with her.Stated that medication is given per doctor's orders and as needed. Said the PRN medication is a last option.
Stated that they don't do anything illegal and give as prescribed.
Administrator stated that Client C1 is given PRN's as needed for agitation and given every 6 hours. Stated she is never given too much and always given per physician's directions.
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.
In regards to the allegation Staff handles resident in an inappropriate manner, based on interviews conducted and information gathered Client C1 stated that she likes Staff S1 and also said Staff S1 has not yelled or done anything physical to her.
Interview with staff who stated that if Client C1 is hitting others they will talk to her and never restrain her.
Also have never seen Staff S1 do anything bad. There is always 3 staff on duty and Client C1's 1 on 1.
Spoke with Administrator who stated that Staff S1 had not been working at all with Client C1. Also said that there are 4 staff on duty and no one had any concerns brought to her attention regarding Client C1.
Client C4 said staff has not done anything physical to the clients.
Interview with Staff S1 who stated he is never working with Client C1 and that her 1 on 1 are with her. Said when Client C1 is having behaviors he will redirect the other clients to their room for safety.
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.
In regards to the allegation Staff yells at resident, based on interviews conducted and information gathered Client C1 stated that Staff S1 has not yelled at her.
Client C4 said staff has not yelled at any clients.
Staff stated that they have not seen Staff S1 act inappropriately and has not yelled at clients.
Said he has a strong and firm voice that is stern, but it isn't yelling.
Administrator stated that Staff S1 has a strong voice, but has not had any complaints regarding yelling at clients. Said there are 3 staff on duty including Client C1's 1 on 1 so doesn't believe it happened.
Interview with Staff S1 who stated he is never working with Client C1 and that her 1 on 1 are with her. Said when Client C1 is having behaviors he will redirect the other clients to their room for safety. Stated always other staff on duty plus her 1 on 1 and they have seen that he has not done anything inappropriate.

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: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2