198603035-9-6-2022-28-AS-RORN-CHZQHJ-20220906121110

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603035
Report Date: 08/25/2022
Date Signed: 09/06/2022 11:55:33 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
05/16/2022 and conducted by Evaluator Christine Wong

COMPLAINT CONTROL NUMBER: 28-AS-20220516144706

FACILITY NAME:	PUENTE HOME		FACILITY NUMBER:	198603035
ADMINISTRATOR:	YASHICA MORROW		FACILITY TYPE:	737
ADDRESS:	1423 E PUENTE AVE		TELEPHONE:	(909) 596-5360
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91791
CAPACITY:	4	CENSUS: 3	DATE:	08/25/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	4		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility is not able to meet resident's needs
Staff speak inappropriately to resident.

INVESTIGATION FINDINGS:

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This report serves as an addendum and supersedes the complaint investigation report created on 5/18/22. This addendum is written to correct the spelling errors and does not change the complaint investigation report findings recorded on 5/18/22

Licensing Program Analyst (LPA) Christine Wong conducted an unannounced initial 10 days complaint investigation and addressed the above allegations. LPA met with the staff John Mejia and explained the reason of the visit. The administrator and program director assisted LPA's visit via telephone.

The investigation consisted of the following: LPA interviewed administrator and program director via telephone, four staff (S1-S4) and three clients (C1-C3). LPA also reviewed all clients' files, visitors log for COVID-19, staff CPI training and obtained copy of C1's Individual Program Plan (IPP).

(See LIC 9099C 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: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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-20220516144706

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: PUENTE HOME	FACILITY NUMBER: 198603035
	VISIT DATE: 08/25/2022

NARRATIVE

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The facility did contact C1's therapist immediately and the therapist did evaluate C1 situation on the phone and stated that she was not in crisis. The facility staff just had to continue to monitor C1 closely. The administrator also reported C1 is currently receiving three therapy/counseling session once a week and monthly and two behavioral therapy weekly. The program director and administrator reported that C1 receives a lot of support from facility staff, medical team and regional center.

Allegation#2" Staff speak inappropriately to residents." LPA interviewed three clients and two out of three clients denied the allegation and reported staff never yelled or cursed at them. Staff are nice people. LPA interviewed staff and staff reported only client speak inappropriately to them. Client would say hurtful, bad and mean things to them. The administrator also reported they would never tolerate staff doing that to clients.

Based on the interviews with client and staff, 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 allegations are UNSUBSTANTIATED

Exit Interview conducted and a copy of this report and appeal right was provided to the Lead Staff- Henry Ray Scott.

NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC9099 (FAS) - (06/04)

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