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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603035
Report Date: 12/12/2024
Date Signed: 12/12/2024 10:00:31 AM

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
12/06/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241206103309
FACILITY NAME:PUENTE HOMEFACILITY NUMBER:
198603035
ADMINISTRATOR:MELISSA VAZQUEZFACILITY TYPE:
737
ADDRESS:1423 E PUENTE AVETELEPHONE:
(626) 331-6331
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:4CENSUS: 4DATE:
12/12/2024
UNANNOUNCEDTIME BEGAN:
07:25 AM
MET WITH:Christala Prudholme/S-1 and Melissa Vazquez/AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff threatened client.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an initial visit to investigate the above allegation. LPA met with Christala Prudholme/S-1 and discussed the purpose of today's visit. Melissa Vazquez (Administrator) arrived at approximately 8:15 A.M..

During today’s visit, LPA Irra obtained a copy of the staff and client roster, interviewed Staff #1 (S-1) through Staff #5 (S-5), interviewed Facility Administrator, interviewed Client #1 (C-1) through Client #3 (C-3) and reviewed file for Client #4 (C-4) and obtained relevant documentation. LPA attempted to interview C-4 and was unsuccessful.

Refer to LIC 9099C for the continuation of this report.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
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-20241206103309
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: 12/12/2024
NARRATIVE
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Allegation: Staff threatened client. It has been alleged that staff threatened to hit a client. Staff interviews revealed that staff do not threaten clients (including hitting clients). Interviewed staff indicated that C-4 has a history of fabricating stories which is being monitored and recorded by staff. Interviewed staff indicated that they have not witnessed any staff threatening clients (including hitting clients). Client interviews revealed that staff do not threaten clients. Interviewed clients indicated that they have not witnessed any staff threatening clients (including S-5 and C-4). Client interviews revealed that staff are nice and respectful and did not have any concerns regarding this matter. Interviews and reviewed documentation do not corroborate this allegation.

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, a copy of the Appeal Rights and this report was provided to Melissa Vazquez.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2