198603436-9-19-2023-28-AS-RORN-CVVSK4-20230921135608

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603436
Report Date: 09/19/2023
Date Signed: 09/19/2023 12:34:18 PM

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
05/12/2023 and conducted by Evaluator Elizabeth Irra

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230512103658

FACILITY NAME:	HIGHPOINTE CARE - FRENCH LANE		FACILITY NUMBER:	198603436
ADMINISTRATOR:	STEWART, REUBEN		FACILITY TYPE:	735
ADDRESS:	430 FRENCH LN.		TELEPHONE:	(562) 682-0946
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY:	4	CENSUS: 3	DATE:	09/19/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Adegboyega Agbelusi/Residential Director		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Personal Rights: Staff engaged in a physical altercation with client resulting in client sustaining injuries.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to investigate the above allegation. LPA met with Adegboyega Agbelusi/Residential Director and discussed the purpose of today’s visit.

On 05/15/23, LPA Irra conducted the initial 10-day complaint visit. LPA met with Casarae Warfield/S-1 and discussed the purpose of this visit. Abidemi "Abi" Raymond (House Manager) arrived at approximately 9:30 A.M.. During this visit, LPA conducted a tour of this facility. LPA did not observe any signs of neglect, abuse or other immediate health and safety threats. LPA reviewed Client #1's (C-1s) file and obtained relevant documentation. LPA obtained copies of the client and staff rosters.

During this investigation, LPA interviewed Staff #1 (S-1) through Staff #3 (S-3), Client #1 (C-1) through Client #4 (C-4), reviewed C-1’s file and obtained relevant documentation. LPA also reviewed the report from San Gabriel Pomona Regional Center pertaining to this incident. **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: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

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-20230512103658

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: HIGHPOINTE CARE - FRENCH LANE	FACILITY NUMBER: 198603436
	VISIT DATE: 09/19/2023

NARRATIVE

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Allegation: Staff engaged in a physical altercation with client resulting in client sustaining injuries. Staff interviews revealed that the only staff present during the alleged physical altercation was S-3. Client interviews revealed that C-1 and C-2 were the only clients present during the alleged physical altercation. However, C-2 did not witness the alleged altercation as C-2 was inside their bedroom. It is alleged that on 05/10/23, while C-1 was cooking hamburger patties, C-1 had the fire flames set on high causing the smoke alarms to activate. Interviews revealed that S-3 attempted to redirect C-1, however, C-1 became upset. S-3 called the police as C-1 allegedly became non-compliant and aggressive. Per interviews, C-1 became physically aggressive towards S-3 causing S-3 to have scratches on the arms and a sprained hand. S-3 did not press charges against C-1, therefore, the Pomona Police Department did not open a case. Injuries to C-1 were not observed. San Gabriel Pomona Regional Center also investigated this allegation, and their finding was “inconclusive”. Interviews and reviewed documentation do not corroborate this allegation.

Based on record review and interviews conducted the findings indicate, although the allegation may have happened or are 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 conducted, appeal rights and a copy of this report was provided to Adegboyega Agbelusi/Residential Director

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC9099 (FAS) - (06/04)

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