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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603402
Report Date: 04/18/2024
Date Signed: 04/18/2024 11:10:46 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
04/12/2024 and conducted by Evaluator Christine Wong
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240412125604
FACILITY NAME:RHEMA CARE GROUP LLC - HOLLY OAK DRIVEFACILITY NUMBER:
198603402
ADMINISTRATOR:IRHIA, BLESSINGFACILITY TYPE:
735
ADDRESS:1820 E HOLLY OAK DRIVETELEPHONE:
(626) 426-5904
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:4CENSUS: 4DATE:
04/18/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:John Wilson TIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Staff hit resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Wong conducted the “Initial 10-Day” visit to ascertain information pertaining to the above-mentioned allegation(s) and to establish the validity of the complaint. LPA met with Staff #1 Jackelyne Huizar (DSP) who allowed entry into the facility and was later met by Administrator John Wilson who assisted with the visit.

The investigation consisted of the following: On today's date, LPA interviewed three staff (S1-S3), four clients (C1-C4) and administrator and reviewed Client#1's documents and obtained copy of documents include: C1's physician report and living option committe notes and referral summary and Individual Program Plan (IPP)

(See LIC 9099C for continuation)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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 2
Control Number 28-AS-20240412125604
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: RHEMA CARE GROUP LLC - HOLLY OAK DRIVE
FACILITY NUMBER: 198603402
VISIT DATE: 04/18/2024
NARRATIVE
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The investigation revealed of the following: Allegation "Staff hit resident." It's alleged that the administrator hit C1's head when C1 was in the shower during weekend. LPA interviewed three out of three clients and all denied the allegation and stated no staff ever hit clients in the facility. All staff are nice to them. Client reported only client hits staff. LPA interviewed staff and all denied the allegation and they never witnessed any staff including the administrator hit clients. Administrator also denied the allegation and stated administrator does not go to the facility during weekend. Administrator also indicated C1 usually goes to mother's house every other weekend and C1 was not able to tell the incident happened on which weekend. In addition, the staff and administrator also stated that client has a history of falsifying information and fabricating story.

Based on the interviews conducted with staff and clients and documents 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.

An exit interview was conducted with Administrator Wilson. A copy of this report along with the appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC9099 (FAS) - (06/04)
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