<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603506
Report Date: 05/22/2023
Date Signed: 05/22/2023 05:10:34 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
02/22/2023 and conducted by Evaluator Bennette Pena
COMPLAINT CONTROL NUMBER: 28-AS-20230222154644
FACILITY NAME:REM CALIFORNIA, LLC - PENNSYLVANIAFACILITY NUMBER:
198603506
ADMINISTRATOR:SALAU, ADEMOLAFACILITY TYPE:
735
ADDRESS:11343 PENNSYLVANIA AVETELEPHONE:
(562) 529-2524
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY:4CENSUS: 3DATE:
05/22/2023
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Divette Bias, Direct Support Professional & Program SupervisorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not ensure staff received proper training
Facility staff left client in soiled bedding overnight
Licensee is not properly addressing insect infestation in facility
Facility staff speak to clients inappropriately
Facility staff yell at clients
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Bennette Pena conducted a subsequent complaint visit to investigate the above allegations. LPA met with Josanne Lambert/Direct Support Professional and Divette Bias/Direct Support Professional (DSP) & Program Supervisor and explained the reason for the visit. At 11:22am, LPA spoke with the Administrator, Ademola Salau and was informed that he will not be able to come and assist with the investigation.

During the initial visit on 3/01/2023, LPA Pena obtained copies of the staff and clients rosters, new employee orientation, weekly cleaning and documentation schedule. A physical plant tour of the facility, interviewed Staff #1-Staff #3 (S1- S3), Client #3-Client #4 (C3-C4), attempted to interview Client #1-Client #2 (C1-C2) but unsuccessful due to their cognitive abilities. LPA requested copies of the exterminator and plumbing service reports and invoices from the Administrator.

During today's visit, LPA Pena obtained copies of the staff and clients rosters, Client #1 (C1) and Client #3 (C3) files such as Physician's Report, Assessment, Face sheet and Admission Agreement, copies of Exterminator invoices (Sep. 2022-Feb 2023), Orientation training list for new hire, tour of the common areas, interviewed Staff #4 (S4) telephonically and Staff #5 (S5) in-person, and attempted to interview Staff #6 (S6) 2x telephonically (@1:43pm & 2:48pm), but calls were not returned. Note that C4 has moved out of the facility and not present in the facility during the subsequent visit. *****CONTINUED ON LIC9099-C*****
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
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 4
Control Number 28-AS-20230222154644
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: REM CALIFORNIA, LLC - PENNSYLVANIA
FACILITY NUMBER: 198603506
VISIT DATE: 05/22/2023
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
The investigation revealed the following:
  • Allegation: Licensee did not ensure staff received proper training.
It is alleged that a new staff member was to be trained by another staff but it did not happen. And the new staff was written up for being alone with the clients without training. Interviews with staff members revealed that prior to allowing a staff to start work at the facility, the new staff receives training from their headquarters first. Then once at the facility, the new staff will be shadowed by the Lead or Senior Staff. The new staff will also go through orientation and other important training concerning the clients and how the house is run. S1 and S5 denied the allegation and stated that they are responsible in training any new staff member. And senior staff members will assist with minor training. Staff members interviewed indicated that they received the orientation training when they first started at the facility. Interviews with C3-C4 revealed that they are not familiar on how the facility train the staff, but has no complaints with how the staff are doing their job. LPA reviewed the in-service training for the staff members and are up-to date. Based on statements and interviews conducted with clients and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

  • Allegation: Facility staff left client in soiled bedding overnight
It is alleged that a staff noticed a client was covered in feces and had been left with feces in his bed when the staff arrived for work. Interviews conducted with staff members revealed that none of the clients wear diapers nor incontinent. S1 and S5 denied the allegation and stated that no one reported this incident. Some staff members stated that they did not not have seen any client left soiled bedding overnight. Staff members indicated that due to some clients' health issues and size, they become smelly. A.M. Shift staff members indicated that they did not see any client covered in feces or had been left with feces because the linens are clean and washed often. Staff members also indicated that there's a roster on who will clean and shows their duties/responsibilities which the staff follows. Interviews conducted with C3-C4 stated that they can go to the bathroom and wipe themselves. They hardly had an accident at night, but if they did, the staff would give them a bath or shower. Based on statements and interviews conducted with clients and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 28-AS-20230222154644
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: REM CALIFORNIA, LLC - PENNSYLVANIA
FACILITY NUMBER: 198603506
VISIT DATE: 05/22/2023
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: "Licensee is not properly addressing insect infestation in facility." It is alleged that the staff has observed cockroaches come out of the freezer for the last two months and the owner does not let the exterminator spray for the roaches. It is also alleged that the staff are not monitored to clean the facility which is why the roaches have not been eradicated. Based on interviews with staff members revealed that they had seen roaches in the facility, but not many and not all over the house. S1 denied the allegation that they do not allow exterminator to spray inside the home. S1 stated that the exterminator comes in regularly to spray in and out of the home. Staff members indicated that whenever they noticed roaches, they would report it to the Administrator and he called the maintenance/exterminator right away. During today's visit, S2, S4-S5 stated that the kitchen was remodelled in Apr. 2023 and they have not seen any roaches since. Clients interviewed stated that they hardly see roaches and do not have any complaints or issues about this. LPA reviewed the exterminator invoices (Sep 2022-Feb 2023) and observed that the facility is being serviced on a monthly basis. Based on statements and interviews conducted with clients and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

Allegation: "Facility staff speak to clients inappropriately." It is alleged that a staff will provoke, antagonize and yell at a client. Interviews conducted with staff members revealed that they have not seen or heard any staff speak inappropriately to clients. Not even staff to staff. Staff members indicated that they will immediately report it to the Administrator if they ever see or hear a staff speak inappropriately to clients. S1 and S5 denied the allegation and stated that they did not receive any report about such incident. If they had received the report, they will immediately meet with the staff and client to resolve the issue. S1 and S5 stated that some staff members speak in a loud and powerful voice but were not yelling or inappropriately speaking with the clients. S1 stated that the staff receive monthly training about clients personal rights and this is incorporated in the training. S5 indicated that some staff have to sound firm when re-directing clients. Staff members also stated that they receive training regularly regarding clients personal rights and proper ways on how to re-direct the clients behaviors. Interviews with C3-C4 revealed that they like all the staff working in the facility. Clients indicated that the staff are good to them and none of the staff yelled or spoke inappropriately to them. Staff interviews, client interviews and reviewed documentation do not corroborate this allegation.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20230222154644
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: REM CALIFORNIA, LLC - PENNSYLVANIA
FACILITY NUMBER: 198603506
VISIT DATE: 05/22/2023
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: Facility staff yell at clients.
It is alleged that a staff heard another staff yelled at a client and that a client has told a staff multiple times that one of the staff provided and brings prohibited items to him. Interviewed staff members stated that they did not hear or saw any staff yelled at clients. S1 stated that some staff speak loudly and some softly, but never witnessed a staff yelled at clients. S5 indicated that some staff have to speak loudly to be able to re-direct clients, but not directly yelling like mad or disrespectful. Staff members also stated that they receive training regularly regarding clients personal rights and are aware that yelling is not an effective way to re-direct clients. S1 and S5 denied the allegation about the prohibited items being brought in, they spoke to the client and staff immediately to investigate. Both the client and the staff denied this. S1 indicated that C3 has a history of leaving the facility unattended or without notice and could have gotten prohibited items by himself. Interviewed staff members stated that they never saw any staff bring in prohibited items to any clients and if they have seen it, they will report it to the Administrator. Clients interviewed stated that they were not yelled at by any staff nor have heard or seen any staff yelled at other clients. Clients also stated that they never saw any staff bring prohibited items to anyone. LPA reviewed documentation about in-service training for staff regarding clients personal rights and observed to be up-to date. Based on statements and interviews conducted with clients and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

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, a copy of this report and Appeals Rights were provided to Divette Bias, Direct Support Professional and Program Supervisor.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4