198603369-9-21-2021-28-AS-CYEE-C8M3QJ-20211109172713

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603369
Report Date: 09/21/2021
Date Signed: 09/21/2021 11:35:19 AM

Unsubstantiated

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
09/07/2021 and conducted by Evaluator LaJean Nicole Spencer

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210907103507

FACILITY NAME:	DAZION INC		FACILITY NUMBER:	198603369
ADMINISTRATOR:	ADEDOLAPO OLUSOJI		FACILITY TYPE:	735
ADDRESS:	734 GLENEAGLES AVENUE		TELEPHONE:	(909) 233-4528
CITY:	POMONA	STATE: CA	ZIP CODE:	91768
CAPACITY:	4	CENSUS: 3	DATE:	09/21/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Adedolapo Olusoji, administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff yelled at a client while in care
Staff mishandled a client while in care
Staff threatened a client while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nicole Spencer conducted a subsequent visit to deliver the findings for the allegations listed above. LPA Spencer met with administrator Adedolapo Olusoji and discussed the purpose of today's visit.

The investigation consisted of the following: During the initial visit on 9/14/21, LPA Spencer took a tour of the physical plant, interviewed the administrator and staff #1-2 (S1-S2). Clients #1-3 (C1-C3) were non-verbal, so interviews were discontinued. During the course of the investigation, LPA Spencer interviewed staff #3 (S3) and attempted to reach C1’s physician but was unsuccessful. LPA obtained copies of the staff roster, client roster, incident reports, hospital discharge/visit summary reports, and investigation report findings from San Gabriel Pomona Regional Center. West Covina Police Department was contacted but stated that no investigation or report was made regarding the incident.

***See LIC9099C for continuation of report***

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: LaJean Nicole Spencer
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

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-20210907103507

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: DAZION INC	FACILITY NUMBER: 198603369
	VISIT DATE: 09/21/2021

NARRATIVE

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Staff yelled at a client while in care

It was alleged that a staff member yelled at a client during a visit to the physician. Staff interviewed stated that S2 and S3 took C1 and C2 to the physician on 9/1/21. C1 was having behaviors including destruction of property and shoving and needed to be redirected. However, administrator and staff denied the allegation that a staff member yelled at the client. All staff interviewed stated that they have been trained on clients' personal rights and have not witnessed or participated in yelling at clients while in care.

Staff mishandled a client while in care

It was alleged that a staff member mishandled a client by swinging the client, forcing the client to sit down in the chair during a visit to the physician. During the visit to the physician on 9/1/21, staff interviewed stated that C1 was having behaviors including destruction of property and shoving and needed to be redirected. However, administrator and staff denied the allegation that a staff member mishandled the client. Staff stated that there was no physical contact with C1, only blocking C1 from grabbing objects or touching others. During one attempt, C1 tried to grab an object and slipped and fell, resulting in a laceration on C1’s eye. The incident report dated 9/1/21 stated that C1 obtained bruising on the right eyelid, and the physician’s visit summary stated that C1 was referred to the emergency room due to the laceration. Staff interviewed stated that they have been trained on clients' personal rights and have not witnessed or participated in mishandling clients while in care.

Staff threatened a client while in care

It was alleged that a staff member threatened a client during a visit to the physician. During the visit to the physician on 9/1/21, staff interviewed stated that C1 was having behaviors including destruction of property and shoving and needed to be redirected. However, administrator and staff denied the allegation that a staff member threatened the client. Staff interviewed stated that they have been trained on clients' personal rights and have not witnessed or participated in threatening clients while in care. The findings from the investigation from San Gabriel Pomona Regional Center also reveal unsubstantiated findings for the allegations, stating lack of evidence due to the fact that only male caregivers accompanied the clients to the physician and that no police investigation was conducted.

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.

An exit interview was conducted and a copy of this report was provided to the administrator.

NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: LaJean Nicole Spencer
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

LIC9099 (FAS) - (06/04)

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