198603477-4-15-2024-28-AS-TVAO-D4DSLW-20240416135857

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603477
Report Date: 04/15/2024
Date Signed: 04/15/2024 09:15:32 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
02/21/2024 and conducted by Evaluator Elizabeth Irra

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240221145502

FACILITY NAME:	JRC TITANIUM CARE HOME INC.		FACILITY NUMBER:	198603477
ADMINISTRATOR:	CANONES, RONEL		FACILITY TYPE:	735
ADDRESS:	212 E LA VERNE AVE		TELEPHONE:	(909) 279-5485
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY:	4	CENSUS: 4	DATE:	04/15/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Blessing Irhia		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff inappropriately handled a client causing them to hit their head on a wall.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Elizabeth Irra conducted an unannounced subsequent visit to investigate the above allegation. LPA was allowed entry by Blessing Irhia. LPA explained the purpose of today's visit.

During the 02/26/24 initial visit, LPA obtained a copy of the staff and client rosters, interviewed Client #1 (C-1) through Client #3 (C-3), interviewed Staff #1 (S-1) and Staff #2 (S-2) and reviewed Client #4 (C-4)'s file and obtained relevant documentation. LPA was unable to interview Client #4 (C-4) as C-4 was not present at the time of this visit. LPA was unable to interview Staff #3 (S-3) nor Staff #4 (S-4) as they were not present at the time of this visit. LPA also interviewed C-4's Service Coordinator from San Gabriel Pomona Regional Center.

During the course of this investigation, LPA was successful with interviewing S-3 through S-5. LPA attempted to interview C-4 and was unsuccessful. San Gabriel Pomona Regional Center conducted their investigation and their findings were inconclusive. **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: 04/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024

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-20240221145502

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: JRC TITANIUM CARE HOME INC.	FACILITY NUMBER: 198603477
	VISIT DATE: 04/15/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Allegation: Staff inappropriately handled a client causing them to hit their head on a wall. It is alleged that on 02/21/24, C-4 reported that while making their bed in the morning, a female group home staff pushed C-4, causing C-4 to hit the top of their head on the wall. (3) out of (4) interviewed clients indicated that they have not been handled inappropriately (including pushing) by any staff and that they have not witnessed any staff handling other clients inappropriately. (1) out of (4) clients indicated they witnessed (on 02/21/24) that C-4 pretended to be pushed (by pushing themself). Interviewed clients indicated that staff are nice and have no concerns. Staff interviews revealed that staff do not inappropriately (including pushing) handle clients. Staff interviews revealed that C-4 has a history of fabricating stories and have self-injurious behavior. Interviewed staff indicated they have not witnessed any staff inappropriately handling clients. Interviewed staff also indicated they are trained in mandated reporting, client rights and zero tolerance. Interviews conducted do not corroborate this allegation.

Based on record review and interviews conducted the findings indicate, 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.

An exit interview conducted, appeal rights and a copy of this report was provided to Blessing Irhia.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2