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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602952
Report Date: 01/18/2024
Date Signed: 01/18/2024 01:03:24 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
01/04/2024 and conducted by Evaluator Kimberly Ramirez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240104100321
FACILITY NAME:A AND M AURORA HOME CAREFACILITY NUMBER:
198602952
ADMINISTRATOR:JOSEPH ESTANISLAOFACILITY TYPE:
735
ADDRESS:555 AUORA DRIVETELEPHONE:
(909) 399-0693
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:4CENSUS: 4DATE:
01/18/2024
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Administrator EstanislaoTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff handled residents in a rough manner
Staff did not provide a comfortable and safe environment
Staff mismanaged resident’s medication
Staff did not seek medical attention for resident
Facility has inadequate supplies
Staff yelled at resident
Staff sleep while on duty
Staff falsified documents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 01/18/2024 to deliver findings and 01/11/2024, conducted initial complaint investigation. LPA Ramirez was met by Administrator Estanislao and explained the purpose of the visit.

The investigation consisted of the following: LPA Ramirez requested and obtained copies of Staff Roster (LIC 500), Client Roster (LIC 9020), Staff #1 - 6 interviews(S1 – S6), Attempted interview of Client#1- 3 (C1-C3), Nearby neighbors-Witness #1-3 (W1-W3) copies of Client #1-4 (C4): Face Sheet, Identification and Emergency Information, San Gabriel/Pomona Regional Center Individual Program Plan (IPP), Facility/Program Special Incident Reports dated 09/2023 through 11/2023, Receipt dated 01/05/2024, Request for supplies from 12/2023 through 01/11/2024, Bi-weekly Employee Summary Report dated 01/01/2024 through 01/14/2024, Employee handbook and physical plant tour.

See 9099-C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
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 3
Control Number 28-AS-20240104100321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: A AND M AURORA HOME CARE
FACILITY NUMBER: 198602952
VISIT DATE: 01/18/2024
NARRATIVE
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The investigation revealed the following. Regarding Allegation(s): Staff handled clients in a rough manner- It is alleged staff handles residents in a rough manner. Six (6) out of six (6) staff denied this allegation. Three (3) out of three (3) nearby neighbors denied observing this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez reviewed four (4) client records. LPA Ramirez observed facility policy on “Hands-Off Policy” that staff signed upon employment. LPA Ramirez observed Special Incident Report (SGPRC Form 641) for client#3 (C3), dated 10/27/2023. LPA Ramirez did not observe SIR to indicate staff handled clients in a rough manner. Although the allegations 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.

Staff did not provide a comfortable and safe environment- It is alleged that facility staff are not providing a comfortable and safe environment for clients by allowing staff to discuss personal life while providing care to clients. Six (6) out of six (6) staff denied this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez reviewed six (6) staff records and did not observe any documentation indicating staff were reprimanded for any inappropriate discussions while clients were present. LPA Ramirez observed facility policy on “Rules of Conduct and Progressive Disciplinary Procedure” that staff signed upon employment. Although the allegations 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.

Staff mismanaged clients’ medication- It is alleged that staff do not give clients’ medication when they need it. Six (6) out of six (6) staff denied this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez reviewed four (4) client Medication Administration Record (MAR) and clients’ prescribed medications. LPA Ramirez did not observe any discrepancies. Although the allegations 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.

Staff did not seek medical attention for client- It is alleged that staff did not seek medical attention. Six (6) out of six (6) staff denied this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez observed SIR for C3 dated 09/29/2023. SIR indicated C3 was experiencing a medical emergency. According to SIR, staff attempted to assist C3 and called 911 to further assist. LPA Ramirez observed facility policy on “Resident Supervision Policy” that staff signed upon employment. Although the allegations 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.

See 9099-C

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240104100321
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: A AND M AURORA HOME CARE
FACILITY NUMBER: 198602952
VISIT DATE: 01/18/2024
NARRATIVE
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Facility has inadequate supplies- It is alleged that the facility does not have adequate hygiene supplies for clients. Six (6) out of six (6) staff denied this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez observed several bottles of 3 in 1 shampoo, conditioner and body wash in the facility hallway closet. LPA Ramirez observed several boxes of adult diapers and changing pads in the hallway closet. Administrator ESTANISLAO provided LPA Ramirez with receipts of hygiene products the facility buys. LPA Ramirez observed eleven (11) bottles of shower gel, itemized on receipt dated 01/05/2024. LPA Ramirez observed two weeks of requested and delivered facility grocery list. LPA Ramirez observed staff requested and received various toiletry products and cleaning solutions. Although the allegations 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.

Staff yelled at client- It is alleged staff yell at clients in care. Six (6) out of six (6) staff denied this allegation. One (1) out of three (3) nearby neighbors (W1-W3) confirm this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez contacted Claremont Police Department (CPD) on 01/10/2024, to confirm if noise complaints or noise disturbance were ever filed against the facility. According to CPD, records did not indicate a noise complaint was ever filed against the facility address. LPA Ramirez observed facility policy on “Acknowledgement of Harassment Policy” that staff signed upon employment. Although the allegations 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.

Staff sleep while on duty- It is alleged staff sleep while on duty. Six (6) out of six (6) staff denied this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez requested and obtained PM timecard for seven (7) PM staff. LPA Ramirez did not observe any irregularities on timecards. LPA Ramirez observed facility policy on “Resident Supervision Policy” that staff signed upon employment. Although the allegations 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.

Staff falsified documents- It is alleged staff falsified documents. Six (6) out of six (6) staff denied this allegation. Due to cognitive impairments, LPA Ramirez was unable to interview three (3) out of four (4) clients present during the visit. LPA Ramirez reviewed facility file and did not observe any irregularities. Staff records and client files are maintained at the facility. Although the allegations 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.

Exit interview conducted and a copy of this report and appeals rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3