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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603489
Report Date: 01/02/2025
Date Signed: 01/02/2025 09:41:23 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
10/26/2024 and conducted by Evaluator Sanjay Vaid
COMPLAINT CONTROL NUMBER: 28-AS-20241026143806
FACILITY NAME:ABOVE AND BEYOND ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
198603489
ADMINISTRATOR:KIMBERLY ALLENFACILITY TYPE:
735
ADDRESS:430 S. MOUNTAINTELEPHONE:
(951) 323-3852
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:4CENSUS: 3DATE:
01/02/2025
UNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Terri Austin, House ManagerTIME COMPLETED:
09:41 AM
ALLEGATION(S):
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Staff engaged in an inappropriate sexual interaction with resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sanjay Vaid conducted a subsequent complaint visit regarding the allegation listed above and issue findings of the investigated complaint. LPA conducted a tour of the facility and did not find any health and safety concerns. Two clients were present at the facility.

On 10/29/24, LPA Vaid conducted an unannounced initial complaint investigation visit, LPA Vaid was met by House Manager-Terri Austin and explained the purpose of the visit. The investigation consisted of the following: LPA Vaid requested and obtained copies of all staff caregivers that have worked at the facility between the dates of 05/2023 to 06/2024. LPA collected Staff schedule, personal records for six (6) male care givers. Conducted interview with 2 (two) staff, client 1, client 2 is nonverbal and client 3 non-verbal is at day program. Physical tour of the facility was conducted, and no health and safety concerns were observed. LPA messaged five (5) staff, awaiting call back.
LPA Vaid received additional information of three (3) female staff that assisted C1 during their stay at the facility between 05/23 thru 06/24 and conducted interviews via telephone and conducted collateral visits on 10/29/24 and 12/03/24 to obtain statements from C1. Con't on 9099C.....

Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
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-20241026143806
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: ABOVE AND BEYOND ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 198603489
VISIT DATE: 01/02/2025
NARRATIVE
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Regarding the allegation: Staff engaged in an inappropriate sexual interaction with resident. It is alleged, while C1 was a resident at the facility between 05/2023 and 06/2024 they had inappropriate sexual interaction with a male staff person. Ten (10) out of ten (10) staff interviewed deny the allegation have stated no complaint was reported during the period of 05/23 to 06/24 related to the allegation. Four (4) out of four (4) clients interviewed could not corroborate the allegation. Two (2) out of two (2) witnesses in the presence of LPA and C1, can confirm C1’s answer and denial of the alleged event. C1 has denied making this allegation and claims no knowledge of the allegation. Based on documentation gathered, interviews conducted, and observations made and witnessed. The findings indicate that, 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.

Exit interview was conducted with Terri Austin, House Manager and a copy of this report, was provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2