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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603436
Report Date: 02/29/2024
Date Signed: 02/29/2024 09:58:09 AM

Substantiated


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
02/22/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240222132722
FACILITY NAME:HIGHPOINTE CARE - FRENCH LANEFACILITY NUMBER:
198603436
ADMINISTRATOR:STEWART, REUBENFACILITY TYPE:
735
ADDRESS:430 FRENCH LN.TELEPHONE:
(562) 682-0946
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY:4CENSUS: 1DATE:
02/29/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Bilikisu Jinadu/S-1 and Adeniran Julius Jose (S-2)TIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff are sleeping during their shift.
Staff are showering, and using a spare room as the staff room during their shift.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced visit to investigate the above allegations. LPA was allowed entry by Bilikisu Jinadu/S-1 and LPA explained the purpose of today’s visit. Adeniran Julius Jose (S-2) arrived at approximately 9:30 A.M..

During this investigation, LPA obtained a copy of the staff roster, conducted a facility tour and reviewed the Corrective Action Plan (CAP) dated 02/11/24 developed by San Gabriel Pomona Regional Center with Adeniran Julius Jose (S-2) in person and via telephone with Oyewole Joseph Jose (S-3).

Refer to LIC 9099C for the continuation of this report.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
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 3
Control Number 28-AS-20240222132722
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: 02/29/2024
NARRATIVE
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Allegation: Staff are sleeping during their shift. Per CAP report, San Gabriel Pomona Regional Center conducted an investigation and noted they were provided with information, including videos, of staff sleeping during various shifts including the NOC shift. This information was reviewed with S-2 and S-3 in which both agreed with the finding. CAP report and confirmation from S-2 and S-3 corroborates this allegation.

Allegation: Staff are showering and using a spare room as the staff room during their shift. Per CAP report, San Gabriel Pomona Regional Center conducted an investigation and noted that they observed the corner bedroom located near the corner bathroom to have staff personal items such as carryon luggage, medication, toothpaste, toothbrush, a bag of food and a make-up bag (per report, these items were removed the day of the on-site investigation visit). San Gabriel Pomona Regional Center confirmed that staff would use the spare room located on the far corner to the left, and sleep and shower as well. This information was reviewed with S-2 and S-3 in which both agreed with the finding. LPA also reviewed the approved Community Care Licensing Division (CCLD) facility sketch and it does not reflect a staff bedroom. Per facility sketch, all bedrooms are designated for clients only. LPA did not observe staff’s personal items inside the client’s rooms during today’s visit. CAP report, confirmation from S-2 and S-3 and review of the facility sketch corroborates this allegation.

Based on LPA's observation and interviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.



California Code of Regulations, title 22 are being cited on the attached LIC 9099D

Exit interview conducted, appeal rights and a copy of this report was provided to Adeniran Julius Jose (S-2).
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240222132722
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/05/2024
Section Cited
CCR
80078(a)
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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs.

This standard is not met as evidence by:
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Administrator to conduct an in-service training to ensure the staff remain awake during all shifts and ensure the staff provide proper care and supervision to clients. Administrator to submit a copy of the staff training curriculum used along with a sign-in sheet with the date, duration of training and
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Per CAP report, San Gabriel Pomona RC conducted an investigation and noted they were provided with information, including videos, of staff sleeping during various shifts including the NOC shift.
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staff signatures to LPA by the POC due date.
Type B
03/05/2024
Section Cited
CCR
80022(b)(7)
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Plan of Operation (b) The plan and related materials shall contain the following: (7) A sketch of the building(s) to be occupied, including a floor plan which describes the capacities of the buildings for the uses intended, room dimensions, and a designation of the rooms to be used for
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Administrator to submit an updated facility sketch to reflect which room will be utilized for staff.
(OR)
submit a written statement indicating that client rooms will not be used for staff purposes and submit to LPA by the POC due date.
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nonambulatory clients, if any.

This standard is not met as evidence by:
Per CAP report, San Gabriel Pomona RC confirmed staff used the spare room located on the far corner to the left, and sleep and shower as well.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3