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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603035
Report Date: 05/09/2025
Date Signed: 05/09/2025 03:48:24 PM

Substantiated


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
05/06/2025 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250506190022
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:
05/09/2025
UNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:Ronnie Chua, AdministratorTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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The licensee does not ensure that all staff are fingerprint cleared/associated to the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit regarding the above allegation. LPA discussed the purpose of the visit with RBT Lead Christala Prudholme. New Administrator Ronnie Chua arrived later.

The investigation consisted of: A physical plant tour was conducted and records were reviewed. Staff (S1- S3) were interviewed. Copies of LIC 500 Personnel Report and April 2025 Timesheets were reviewed/obtained. The facility does not have any staff files for the recently hired and reliever staff. No health and safety concerns were observed.

**See 9099C for report continuation.

Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025
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-20250506190022
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: 05/09/2025
NARRATIVE
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Allegation: The licensee does not ensure that all staff are fingerprint cleared/associated to the facility. It is alleged there are four (4) staff that are not fingerprint cleared and three (3) staff that are not associated to the facility. Based on staff interviews conducted, the findings indicate the seven (7) staff identified as not being finger print cleared and/or associated are used as reliever staff due to staff shortages or recently began working at the facility. Additionally, record review revealed an additional three (3) staff, are also not associated to the facility. Therefore, nine (9) staff are not associated to the facility and one (1) staff does not have criminal record clearance. On April 25, 2025, new Administrator Ronnie Chua began working at the facility. According to records review, new Administrator is also not associated to the facility. Staff interviewed stated that due to split shift hour changes several staff quit, and as a result there were staffing shortages. In order to fill the staffing needs, licensee brought in reliever staff to cover shifts. There are no staff file documents of the reliever staff. However, time sheets and staff schedules confirm the staff identified on this complaint worked at the facility without being associated and/or finger print cleared. There is sufficient evidence to corroborate the allegation.

Based on interviews conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiencies are cited according to Title 22. See LIC 9099D. Civil penalties were assessed.

Exit interview was conducted with new Administrator Ronnie Chua. A copy of the report and appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20250506190022
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/10/2025
Section Cited
CCR
80019(e)(3)
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Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 80019(f) or.... This requirement was not met evidenced by:
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Licensee shall associate by tomorrow staff [S1-S4 & S6-S10] listed on the provided list (LIC 811) as not associated. Submit proof that the staff were associated via Guardian.
**Civil penalties were assessed in the amount of $4,500.00
NOTE: Staff will exemptions must be associated by CBCB department, and may not return to work until transfer is processed.
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Based on record review, a total of nine (9) staff [S1-S4 & S6-S10] are not associated to the facility, and have been working at the facility as relievers or were recently hired. This poses an immediate health, safety or personal rights risk to persons in care.
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Type A
05/10/2025
Section Cited
CCR
80019(e)(2)
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Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department or.. This requirement was not met evidenced by:
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Licensee shall ensure all staff are finger print cleared prior to beginning employment at the facility. Submit proof by tomorrow that S5 was finger print cleared.

*Civil penalty in the amount of $100.00 was assessed.

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Based on record review, one (1) staff (S5) listed on LIC 811 is does not have criminal background clearance. The staff person worked at the facility on 4/18/25, as a reliever staff to fill in for staff shortages. This poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3