198603436-2-14-2023-28-AS-TVAO-CP9UZY-20230221150216

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603436
Report Date: 02/14/2023
Date Signed: 02/14/2023 12:58:49 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
09/14/2022 and conducted by Evaluator Elizabeth Irra

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220914090430

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: 2	DATE:	02/14/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Ekundayo Daniel Aleburu (Assistant Administrator)		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Client sustained an injury while in care
Due to lack of supervision client engaged in physical and verbal altercations with each other
Staff failed to provide a safe and comfortable environment for clients
Staff yelled at client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent complaint visit to investigate the above allegations. LPA was allowed entry by Ekundayo Daniel Aleburu (Assistant Administrator). LPA explained the purpose of today's visit.

LPA Irra conducted the initial investigation visit on 09/16/2022. During this visit, LPA obtained a copy of the staff roster, client roster, reviewed client files for Client #2 through Client #4 (C-2 through C-4) and obtained relevant documentation. Client #1 (C-1) moved into this facility on 09/15/22 (not present during this alleged incident). LPA also interviewed Staff #1 (S-1) through Staff #4 (S-1 through S-4). Client #3 (C-3) and Client #4 (C-4) signed out of this facility during LPAs visit. LPA was unable to interview Client #2 (C-2) as C-2 was at school during this visit. LPA also called the placement agency service coordinator and left a voice mail message for a return call.

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: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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-20220914090430

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: 02/14/2023

NARRATIVE

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During today’s visit, LPA was informed that C-3 and C-4 no longer reside at this facility. During this investigation, LPA was able to interview C-2 and San Gabriel Pomona Regional Center (placement agency-Service Coordinator/SC). LPA also reviewed files for S-1 through S-4 and obtained relevant documentation.

Allegation: Client sustained an injury while in care. Staff interviews revealed C-3 nor C-4 did not sustain any injuries while residing at this facility. Per staff interviews there has not been any incidents in regards to C-2 grabbing nor scratching anyone (including C-4). Per staff interviews C-4’s glasses have not been thrown on the ground nor have been broken. Per documentation, C-3 and C-4 have a history of fabricating stories and this behavior was being tracked and reported to the behaviorist. (2) out of (4) clients no longer reside at this facility and have a history of fabricating stories. (1) out of (4) clients has recently moved into this facility. (1) out of (4) clients indicated there has not been any injuries while in care. San Gabriel Pomona Regional Center (SC) confirmed that (2) out of (4) clients no longer reside at this facility and have a history of fabricating stories. San Gabriel Pomona Regional Center (SC) also indicated there has not been any reports on C-3 nor C-4 in regards to any injuries sustained while residing at this facility.

Allegation: Due to lack of supervision client engaged in physical and verbal altercations with each other. Staff interviews revealed that they have not witnessed C-2 name calling, using profanity, threatening, intimidating nor provoking C-3 nor C-4. Staff interviews and documentation reviewed indicates that on 09/09/22, C-2 was “cracking jokes and playing” with C-4 but C-4 became upset and began speaking rudely and began insulting C-2 and as a result, both C-2 and C-4 began arguing. During this incident, staff immediately intervened and separated both C-2 and C-4 to avoid an altercation. Staff took C-2 “out of the facility for a walk to calm the situation” and the other staff was in the facility with C-4. Per staff interviews, there was no physical altercation between C-2 and C-4 during this incident. Staff interviews and documentation reviewed indicates that on 09/12/22, C-3 was blocking C-2’s way into the laundry room by standing and blocking the entrance. C-2 was attempting to retrieve laundry and C-3 refused to give C-2 access. C-2 then decided to go through the side. Per documentation reviewed, C-3 “stretched C-3’s left hand and hit C-2 on the back” (witnessed by staff). Staff immediately intervened and redirected both C-2 and C-3. Staff took C-2 for a walk and C-3 went to their bedroom. Per staff interviews, C-2 did not hit nor threaten C-3. Per documentation, C-3 and C-4 have a history of fabricating stories and this behavior was being tracked and reported to the behaviorist. **Refer to LIC 9099C for the continuation of this report**

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20220914090430

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: 02/14/2023

NARRATIVE

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Allegation: Staff failed to provide a safe and comfortable environment for clients. Interviewed staff indicated clients are provided with a safe and comfortable environment. Staff interviews revealed that staff have not received any concerns/complaints in regards to staff not providing safe and comfortable environment for clients. Interviewed staff also indicated they are trained in mandated reporting, client rights and zero tolerance. (2) out of (4) clients no longer reside at this facility and have a history of fabricating stories. (1) out of (4) clients has recently moved into this facility. (1) out of (4) clients indicated staff provide a safe and comfortable environment. San Gabriel Pomona Regional Center Service Coordinator confirmed that (2) out of (4) clients no longer reside at this facility and have a history of fabricating stories. San Gabriel Pomona Regional Center Service Coordinator also indicated staff provide a safe and comfortable environment for clients.

Allegation: Staff yelled at client. Interviewed staff indicated staff do not yell at clients. Staff interviews revealed that staff have not received any concerns/complaints in regards to staff yelling at clients. Interviewed staff also indicated they are trained in mandated reporting, client rights and zero tolerance. (2) out of (4) clients no longer reside at this facility and have a history of fabricating stories. (1) out of (4) clients has recently moved into this facility. (1) out of (4) clients indicated staff do not yell at clients. San Gabriel Pomona Regional Center Service Coordinator confirmed that (2) out of (4) clients no longer reside at this facility and have a history of fabricating stories. San Gabriel Pomona Regional Center Service Coordinator also indicated staff do not yell at clients.

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 and appeal rights and a copy of this report was provided to Ekundayo Daniel Aleburu (Assistant Administrator)

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC9099 (FAS) - (06/04)

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