198603035-6-27-2023-28-AS-RORN-CVNNTP-20230914104503

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603035
Report Date: 06/27/2023
Date Signed: 06/27/2023 04:53:17 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
06/26/2023 and conducted by Evaluator Christine Wong

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230626141658

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: 4	DATE:	06/27/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Christala Prudholme		TIME COMPLETED:	05:10 PM

ALLEGATION(S):

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Client does not feel safe at facility
Facility staff physically assaulted client which resulted in injury

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Wong conducted an 24 hours health and safety check and initial 10 days complaint visit for the above allegation(s). LPA met with DSP Aniena Akpanudosen (Ann) and allowed the entry of the facility and explained the reason of the visit. The interim Administrator Melissa Vasquez arrived after and assisted with the visit.

The investigation consisted of the following: LPA interviewed four clients (C1-C4), interim administrator, three staff (S2-S4) in the facility and attempted to interview Staff#1 (S1). LPA also obtained the copy of C1's behavioral progress update and IPP.

(See LIC 9099C for continuation)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

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-20230626141658

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: PUENTE HOME	FACILITY NUMBER: 198603035
	VISIT DATE: 06/27/2023

NARRATIVE

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The investigation revealed of the following: Allegation#1 "Client does not feel safe at facility" LPA interviewed four clients and three out of four clients denied the allegation and reported they all feel safe living in the facility. All the staff treat them good. LPA interviewed staff and reported C1 always wanted to move out and live independently. C1 would also feel unsafe every time finished arguing with staff and clients. Interim Administrator stated that she did advocate for C1 and wrote an email to C1's service coordinator and brought up during the monthly meeting about C1's concerns but nothing happened yet.

Allegation#2 "Facility staff physically assaulted client which resulted in injury" LPA interviewed four clients and three out of four clients reported they never witnessed any staff physically assaulted clients and staff never hit them or put hands on them. All the staff and administrator reported they had not had CPI on C1 for a long time. The last time C1 had CPI was back in September, 2022. No staff ever witnessed any staff was hitting clients or being mean to clients in the facility. The police did come regarding C1 on 6/8/23 and check on C1 in the facility, they left without incident and the matter was not elevated. In addition, upon review C1's Individual Program Plan (IPP), C1 has a history of making false allegation and the behavior was addressed in C1's behavioral support plan.

Based on the interviews conducted with staff and clients and documents reviewed, 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 DSP Christala Prudholme

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023

LIC9099 (FAS) - (06/04)

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