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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603217
Report Date: 11/15/2022
Date Signed: 11/15/2022 09:43:32 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
04/23/2021 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20210423154505
FACILITY NAME:DEL SOL HOME (CARPINTERO)FACILITY NUMBER:
198603217
ADMINISTRATOR:GONZALES, MERCIFACILITY TYPE:
735
ADDRESS:17926 CARPINTERO AVETELEPHONE:
(562) 243-4234
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:4CENSUS: 4DATE:
11/15/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Merci Gonzales/S-1TIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Client is sexually abused while in care
Client is being drugged while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to investigate the above allegations. LPA met with Merci Gonzales/S-1 and explained the purpose of today's visit.

On 04/16/2021, LPA Irra and Alberto Lopez conducted the initial visit. During this visit, LPAs conducted a tour of the building and grounds and did not observe any signs of neglect, abuse or other immediate health and safety threats. LPAs obtained documentation relevant to this complaint for Client #1 (C-1) and Client #2 (C-2). LPAs also obtained a copy of the Staff Roster with contact information and Client Roster. LPAs unable to interview C-1 as C-1 was asleep during this visit. LPAs attempted to interview C-2, however, C-2 was unable to provide information. LPAs unable to interview C-3 and C-4 as both were hospitalized.

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: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
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-20210423154505
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: DEL SOL HOME (CARPINTERO)
FACILITY NUMBER: 198603217
VISIT DATE: 11/15/2022
NARRATIVE
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On 10/25/2022 (latest attempt), LPA attempted to interview C-1 (hospitalized) and was unable to interview after numerous attempts were made. On 10/11/2022, LPA attempted to interview C-3 and was unable to interview as C-3 is non-verbal and unable to understand interview questions. LPA was unable to interview C-4 as C-4 is no longer at this facility. C-5 did not reside at this facility at the time of these allegations. On 10/18/2022, LPA interviewed Staff #1 through Staff #3. On 10/22/2022, LPA followed up with the Placement Agency Quality Assurance in regards to these allegations.

Allegation: Client is sexually abused while in care During this investigation, LPA attempted to interview C-1 through C-4 and was unsuccessful. LPA attempted to interview C-1 with no success. C-2 and C-3 were non-verbal and unable to understand interview questions. LPA was unable to interview C-4 as C-4 is no longer at this facility. C-5 did not reside at this facility at the time of these allegations. LPA interviewed Facility Administrator, S-1 through S-3 and Placement Agency Quality Assurance. Interviews conducted and documentation reviewed revealed that C-1 has a history of fabricating stories including allegations of being sexually abused. Per staff interviews, C-1’s behavior of fabricating stories is being monitored, recorded and reported to C-1’s behaviorist. Per staff interviews, they have not witnessed nor received any concerns from others in regards to clients being sexually abused. Per staff interviews, there is a female staff on shift that attends to C-1’s activities of daily living due to C-1’s history of fabricating stories. Interviews and documentation reviewed do not corroborate this allegation.



Allegation: Client is being drugged while in care During this investigation, LPA attempted to interview C-1 through C-4 and was unsuccessful. LPA attempted to interview C-1 with no success. C-2 and C-3 were non-verbal and unable to understand interview questions. LPA was unable to interview C-4 as C-4 is no longer at this facility. C-5 did not reside at this facility at the time of these allegations. LPA interviewed Facility Administrator, S-1 through S-3 and Placement Agency Quality Assurance. Interviews conducted and documentation reviewed revealed that C-1 has a history of fabricating stories. Per staff interviews, C-1’s behavior of fabricating stories is being monitored, recorded and reported to C-1’s behaviorist. Per staff interviews, they have not witnessed nor received any concerns from others in regards to clients being drugged. Interviews and documentation reviewed do not corroborate this allegation.

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

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 28-AS-20210423154505
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: DEL SOL HOME (CARPINTERO)
FACILITY NUMBER: 198603217
VISIT DATE: 11/15/2022
NARRATIVE
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Based on LPA observation and interviews conducted, there was not sufficient evidence to concur with these allegations. 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 was conducted, appeal rights and a copy of this report was provided to Merci Gonzales/S-1.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3