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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603424
Report Date: 03/11/2024
Date Signed: 03/11/2024 03:07:12 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
03/01/2024 and conducted by Evaluator Jose Villalobos
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240301163457
FACILITY NAME:NEW HOPE HOME CAREFACILITY NUMBER:
198603424
ADMINISTRATOR:MANZANO, CARMENCITAFACILITY TYPE:
735
ADDRESS:2146 VIRGINIA AVE.TELEPHONE:
(909) 306-7757
CITY:POMONASTATE: CAZIP CODE:
91766
CAPACITY:4CENSUS: 3DATE:
03/11/2024
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Administrator Carmencita Manzano TIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff speaks inappropriately to resident
Staff do not ensure that resident's dietary needs are met
Staff do not provide a comfortable environment for resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose Villalobos conducted a subsequent visit for the allegation above. LPA met with Administrator Carmencita Manzano and the purpose of the visit was discussed.

Initial visit conducted on 3/8/24 consisted of the following: LPA toured the physical plant. LPA Interviewed staff #1-#3 (S1-S3) and clients #1-#2 (C1-C2). LPA reviewed and collected documents from C1's file as well as from Staff #4's (S4) file. As of today, LPA has also interviewed Staff #4 (S4).

The investigation revealed the following:
In regards to the allegation "Staff speaks inappropriately to resident" it was alleged that S4 has called C1 a "big baby" and a racist in the facility. (4) of (4) Staff interviewed denied the allegation. (1) of (2) Clients interviewed could not corroborate the allegation. S4 denied speaking to C1 in any inappropriate way and has never called C1 a racist. C1 was not able to provide a date of when S4 spoke inappropriately to them and even changed the date during conversations.... Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2024
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-20240301163457
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: NEW HOPE HOME CARE
FACILITY NUMBER: 198603424
VISIT DATE: 03/11/2024
NARRATIVE
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File review does show that C1 has a history of making false statements in the past. LPA did not observe any staff speaking inappropriately to C1 during both visits. Based on interviews, files reviewed and observations; 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.

In regards to the allegation "Staff do not ensure that resident's dietary needs are met" it was alleged that facility staff rush C1 to finish their meals. (4) of (4) Staff interviewed denied the allegation. (1) of (2) Clients interviewed could not corroborate the allegation. Interviews show that on 2/29/24 C1 had a doctors appointment in the morning at 10am. By 9:20am, S4 arrived to provide transportation for C1 but C1 was not ready as C1 had not begun to eat their breakfast. Interviews stated that C1 was provided their breakfast at 8:45am when C1 took it to eat in their room. Interviews stated that C1 claimed that staff provided the breakfast late and will not be ready on time. Staff interviewed denied rushing C1 and stated they provided C1 a reminder to finish their meal as C1 had an appointment to go to. Staff stated that C1 is on a specific diet as set forth by a dietitian so it is important for C1 to eat the meals provided. File review shows that C1's dietary needs are mentioned in C1's Individual Program Plan (IPP) and there is a food menu specifically for C1. C1 stated that they receive the meals on the plan and have not missed meals. LPA observed C1 receiving meals from their personal menu during both visits. LPA was not provided with proof that staff are not ensuring residents dietary needs are being met because they rush C1 to eat. Based on interviews, files reviewed and observations; 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.

In regards to the allegation "Staff do not provide a comfortable environment for resident" it was alleged the staff make the facility uncomfortable for C1 because staff speak a different language other than English. (4) of (4) Staff interviewed denied the allegation. (1) of (2) Clients interviewed could not corroborate the allegation. Staff interviewed stated that they will not speak to Clients in any other language other than English. They stated it is true that among themselves they speak a different language but conversations are not to make any clients uncomfortable. C2 stated to have no issues in communication with staff and that staff will speak in English with them all the time. LPA observed staff speaking in English to clients in care during both visits. Based on interviews, files reviewed and observations; 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 conducted and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2024
LIC9099 (FAS) - (06/04)
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