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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603525
Report Date: 12/12/2024
Date Signed: 12/12/2024 12:45:39 PM

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
12/04/2024 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241204170716
FACILITY NAME:LAMBERT PLACE, THEFACILITY NUMBER:
198603525
ADMINISTRATOR:ALVAREZ, EDUARDOFACILITY TYPE:
737
ADDRESS:13304 LAMBERT RDTELEPHONE:
(909) 631-8521
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY:3CENSUS: 3DATE:
12/12/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Adrianna Harbin-Assistant AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility is not following program plan.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted an initial complaint visit to investigate the above allegation. LPA met with Adrianna Harbin/Assistant Administrator and discussed the purpose of today's visit.

During this visit, LPA obtained a copy of the staff and client rosters, copies of the consultant logs (for speech services provided by a contractor), automobile and workers’ compensation insurance coverages and conducted a tour. LPA reviewed the Corrective Action Plan (CAP) addressing the above allegation issued by Eastern Los Angeles Regional Center dated 12/04/24 with Adrianna Harbin. Per Ms. Harbin, she is in agreement with the CAP findings and will be complying with the CAP.

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: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
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-20241204170716
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: LAMBERT PLACE, THE
FACILITY NUMBER: 198603525
VISIT DATE: 12/12/2024
NARRATIVE
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Allegation: Client medication errors. It has been alleged that this facility is out of compliance by not following the program plan. Per issued Corrective Action Plan (CAP) dated 12/04/24, this facility is out of compliance by not having a delayed egress system as indicated in their program design, the facility was unable to provide business liability, automobile, and workers' compensation insurance policy and that this facility did not have a source verification for the consultant hours being provided by the contractor. LPA confirmed above information with Ms. Harbin. Per Ms. Harbin, she is in agreement with the CAP findings and will be complying with the CAP. During LPA’s tour, LPA observed the door in the front gate leading to the front entrance door did not have delayed egress and the back gate was open upon LPA’s arrival. Per CAP report, Ms. Harbin’s agreement to the CAP and tour this corroborates this allegation.

Based on interviews conducted and document review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. Deficiency is being cited according to California Code of Regulations, Title 22. Refer to LIC 9099D.

Exit interview conducted, appeal rights and this report was provided to Adrianna Harbin/Assistant Administrator.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20241204170716
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: LAMBERT PLACE, THE
FACILITY NUMBER: 198603525
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
12/16/2024
Section Cited
CCR
80022(k)
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Plan of Operation (k) The facility shall operate in accordance with the terms specified in the Plan of Operation and may be cited for not doing so.
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Administrator to submit a written plan as to how this facility will be in compliance with following the approved plan of operation and submit to LPA Irra by POC due date of 12/16/24.
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This standard is not met as evidence by: Please refer to page 2 of this report for details.
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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: 12/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3