198603035-6-3-2025-28-AS-DSIS-DHLPKH-20250613112308

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603035
Report Date: 06/03/2025
Date Signed: 06/03/2025 11:21:18 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
03/24/2025 and conducted by Evaluator Daniel Konishi

COMPLAINT CONTROL NUMBER: 28-AS-20250324091613

FACILITY NAME:	PUENTE HOME		FACILITY NUMBER:	198603035
ADMINISTRATOR:	MELISSA VAZQUEZ		FACILITY TYPE:	737
ADDRESS:	1423 E PUENTE AVE		TELEPHONE:	(626) 331-6331
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91791
CAPACITY:	4	CENSUS: 4	DATE:	06/03/2025
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Ronnie Chua, Administrator		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff suffocated a client while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Daniel Konishi conducted an subsequent unannounced complaint visit at the facility and met with the Administrator, Ronnie Chua to discuss the purpose of the visit. The purposed of the visit is to investigate the above allegation.

On 04/25/2025, the initial investigation visit was conducted. The investigation consisted of the following:
LPA interviewed the Administrator, Staff #1 (S1) and Client #1 (C1) to Client #3 (C3). LPA interviewed Staff #2 (S2) over the phone. LPA attempted but unable to interview Staff #3 (S3) over the phone due to no reply. LPA unable to interview Client #4 (C4) since C4 was out of the home and in the community. LPA also obtained the staff, client rosters, special incident report, and restraint debriefing form.

On 06/02/2025, LPA Konishi interviewed Client #4 (C4), Witness #1 (W1), Staff #5 (S5) and Staff #6 (S6) over the phone.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Daniel Konishi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

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-20250324091613

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PUENTE HOME	FACILITY NUMBER: 198603035
	VISIT DATE: 06/03/2025

NARRATIVE

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During today's visit, LPA obtained the following documents: staff and client rosters. LPA reviewed staff’s valid CPI training certifications, ongoing staff training, and documents from C1’s file which includes the face sheet, current IBSP (Individual Behavioral Service Plan), preplacement appraisal, and LIC613 Personal Rights. LPA interviewed S3.

The investigation revealed the following: in regards to the allegation "Staff suffocated a client while in care.” it is alleged that on 02/18/2025 at about 8:00 pm, a staff member put a jacket over the C1's head and covering C1’s nose and mouth. The Administrator and five (5) out of five (5) interviewed denied the allegation. W1 denied the allegation. The administrator and five (5) out of five (5) staff interviewed indicated that they have never suffocated the clients in care nor have they observed any other staff members suffocate any clients in care. Interview with Staff and W1 indicated that C1 and C2 has a documented history of violent behaviors. Per document obtained dated 05/19/2025, C1 has a history of violent behaviors and making false allegations. In a Special Incident Report obtained indicated that on 02/18/2025 around 8:20pm, C1 was being verbally and physically aggressive and damaging property so two staff CPI hold for 30 seconds was placed on C1. No items such as the jacket were used nor any injuries were noted at the time of the incident. One (1) out of four (4) clients corroborated with the allegation. Two (2) out of (4) clients interviewed denied the allegation and stated never getting suffocated nor hurt by the staff. One (1) out of (4) clients denied the allegation but stated being grabbed by staff in the past. The clients interviewed also could not provide specific details regarding when this alleged physical abuse occurred. In addition, there were no witnesses that observed these incidents. No paperwork observed in the files that showed the staff have been reprimanded for physical abuse. All staff interviewed indicated that they placed CPI holds as required on the clients when necessary. LPA reviewed five (5) staff files and all have valid CPI Certifications and ongoing staff training on CPI, Personal Rights, and Abuse Prevention in file. W1 stated that C1 and C2 have documented history of fabrications and makings false allegations. W1 also stated that C1 has documented history of delusions, hallucinations, and paranoia. W1 also does not have any documentation in the month of February 2025 of C1 being suffocated by staff. There was insufficient evidence to corroborate with the allegations.

[Continue in LIC9099-C]

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Daniel Konishi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250324091613

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PUENTE HOME	FACILITY NUMBER: 198603035
	VISIT DATE: 06/03/2025

NARRATIVE

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Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview held with the Administrator, Ronnie Chua and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Daniel Konishi
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/03/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025

LIC9099 (FAS) - (06/04)

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