198603563-9-1-2023-28-AS-LHIS-CVPJM7-20230915070949

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603563
Report Date: 09/01/2023
Date Signed: 09/01/2023 09:36:40 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/21/2023 and conducted by Evaluator Jewel Baptiste

COMPLAINT CONTROL NUMBER: 28-AS-20230821110615

FACILITY NAME:	TELECARE CITRUS HOUSE		FACILITY NUMBER:	198603563
ADMINISTRATOR:	SAWLSVILLE, BRIAN		FACILITY TYPE:	772
ADDRESS:	7725 LEEDS STREET		TELEPHONE:	(925) 250-5288
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90242
CAPACITY:	16	CENSUS: 14	DATE:	09/01/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Administrator Bryan Sawlsville		TIME COMPLETED:	09:51 AM

ALLEGATION(S):

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Staff unlawfully evicted a client while in care

INVESTIGATION FINDINGS:

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On 9/01/23 at 9:00 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced complaint visit to deliver findings. Upon arrival LPA met with Administrator Bryan Sawlsville and explained the purpose of the visit.

During the initial visit LPA toured the facility with Administrator. LPA obtained resident roster and staff roster. LPA interviewed: Administrator and a total of One (1) staff who shall be referred to as S1.LPA attempted to contact S2 three times and left a text message. LPA also interviewed a total of 4 residents who shall be referred to as: R1 through R4.

During today’s visit LPA toured the facility with Administrator. LPA received a copy of the staff roster, resident roster and R1 discharge paperworked dated 8/19/2023.

Report continued 9099c

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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-20230821110615

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: TELECARE CITRUS HOUSE	FACILITY NUMBER: 198603563
	VISIT DATE: 09/01/2023

NARRATIVE

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The investigation reveals the following: Regarding "Staff unlawfully evicted a client while in care”. During the visit LPA interviewed the administrator. The Administrator denied the allegation stating the facility sent R1 to the emergency room to have R1 evaluated and not evicted. 1 out 2 staff stated R1 was not evicted, staff was concerned because R1 arrived without 3 important medications and started having symptoms such as severe pain. 1 out of 2 staff denied the allegation stating that R1 was complaining of pain and staff called the ambulance. During the process staff stated that the assure R1 there room will be on hold and that they will be able to return after hospitalization. 3 out of 4 residents denied the allegation stating the facility has never tried to evict the residents unless they test positive for drugs. 1 out of 4 residents confirmed the allegation stating they were told verbally by staff that they were going to be kicked out the program. LPA was not able to obtain documentation of eviction due to the facility stating they have never given the resident an eviction notice.

Based on LPA's interviews, investigation revealed: 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.

Exit interview conducted with Bryan Sawlsville and a copy of this record provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC9099 (FAS) - (06/04)

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