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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603424
Report Date: 05/02/2024
Date Signed: 05/02/2024 10:14:53 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
04/26/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240426160719
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:
05/02/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Remy ColemanTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility staff not properly supervising client in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced visit to investigate the above allegation. LPA met with Remy Coleman and explained the purpose of today's visit.

During this visit, LPA obtained copies of the staff and client rosters, interviewed Staff #1 (S-1) through Staff #4 (S-4), interviewed Client #1 (C-1) through Client #3 (C-3) and reviewed C-3’s file and obtained relevant documentation.

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: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
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-20240426160719
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: NEW HOPE HOME CARE
FACILITY NUMBER: 198603424
VISIT DATE: 05/02/2024
NARRATIVE
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Allegation: Facility staff not properly supervising client in care. It is alleged that when C-3 goes out for outings (shopping or medical appointments), S-4 takes C-3 to the music store. It is alleged that C-3 stays unsupervised inside the car for up to 30 minutes. Staff interviews revealed that clients are taken to outings and are always supervised. Staff interviews revealed that staff do not leave clients alone inside the car. Interviewed staff indicated they have not received any concerns/complaints in regards to this matter. Interviewed staff also indicated that C-3 has a history of fabricating stories. (2) out of (3) interviewed clients indicated that staff provide supervision while in outings. (2) out of (3) interviewed clients indicated that they are not left unsupervised inside the staff’s car. Staff and client interviews do not corroborate this allegation.

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 conducted, a copy of this report and appeal rights were provided to Remy Coleman.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2