198603384-3-19-2024-28-AS-FFIS-D3QM9K-20240326092449

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603384
Report Date: 03/19/2024
Date Signed: 03/19/2024 03:11:40 PM

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
03/12/2024 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240312142800

FACILITY NAME:	PASADENA HIGHLANDS		FACILITY NUMBER:	198603384
ADMINISTRATOR:	KAY CANO		FACILITY TYPE:	740
ADDRESS:	1575 E WASHINGTON BLVD		TELEPHONE:	(801) 815-0808
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	245	CENSUS: 187	DATE:	03/19/2024
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Administrator Kay Cano		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Wrongful Eviction.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced initial complaint investigation visit for the allegation listed above. LPA Villalobos met with Administrator Kay Cano and the purpose of the visit was discussed.

LPA conducted the following: Interviewed staff #1-#6 (S1-S6), Interviewed residents #1-#6 (R1-R6) , interviewed R1 and R2's Responsible Party (W1), collected copies of the staff and resident roster, and collected and reviewed documents from R1 and R2's file.

The investigation revealed the following:

In regards to the allegation "Wrongful Eviction" it was alleged that the facility is wrongfully evicting R1 and R2 due to false belief that the residents are unable to follow facility policies...

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Jose Villalobos	TELEPHONE: (323) 980-4939
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

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-20240312142800

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: PASADENA HIGHLANDS	FACILITY NUMBER: 198603384
	VISIT DATE: 03/19/2024

NARRATIVE

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(6) of (6) Staff Interviewed denied the allegation. (6) of (6) Residents interviewed could not corroborate the allegation. Interviews do not show that R1 or R2 were ever provided an eviction notice from any staff of the facility either verbally or written. LPA was informed that R1 and R2 are moving out of the facility by choice. LPA confirmed that information with R1, R2 and W1. LPA reviewed R1 and R2's file and did not observe any eviction notices on file. LPA reviewed an email correspondence between the facility and W1 where W1 provided the facility a 30 day notice that R1 and R2 will be moving out of the facility. LPA did not observe wrongful eviction in place regarding R1 and R2. Based on interviews, observations and files reviewed; although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview held, and a copy of this report was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Jose Villalobos	TELEPHONE: (323) 980-4939
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

LIC9099 (FAS) - (06/04)

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