198603634-6-15-2023-28-AS-TVAO-CTPM8N-20230713092322

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603634
Report Date: 06/15/2023
Date Signed: 06/15/2023 03:42:23 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
06/14/2023 and conducted by Evaluator Elizabeth Irra

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230614112216

FACILITY NAME:	ANEW DAWN ADULT LIVING		FACILITY NUMBER:	198603634
ADMINISTRATOR:	DUFRENNE, PATRIA MARAVILLA		FACILITY TYPE:	735
ADDRESS:	4340 LOCKWOOD AVE		TELEPHONE:	(323) 426-9123
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90029
CAPACITY:	94	CENSUS: 33	DATE:	06/15/2023
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Glacie May San Juan and Richard Tan		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Illegal eviction.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elizabeth Irra conducted the initial visit to investigate the above allegation. LPA met with Glacie May San Juan and Richard Tan. Patria Dufrenne (Administrator) arrived at approximately 2:20PM to assist with this visit.

During this visit, LPA obtained a copy of the Client Roster, Staff Roster, reviewed file for C-1 and obtained relevant documentation, interviewed Staff #1 (S-1), Staff #2 (S-2), Administrator and attempted to interview Client #1 (C-1).

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: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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-20230614112216

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: ANEW DAWN ADULT LIVING	FACILITY NUMBER: 198603634
	VISIT DATE: 06/15/2023

NARRATIVE

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Allegation: Illegal eviction. Staff interviews revealed that C-1 has not been illegally evicted. Per staff interviews, on 06/12/23, C-1 was agitated, had been yelling and talking loudly inside the facility. On 06/12/23, the PET Team Ambulance came, picked up C-1 and took C-1 to Exodus Recovery. On 06/13/23, C-1 was discharged from Exodus Recovery as C-1 was calm and the 51/50 hold was discontinued. Later the same day (06/13/23), C-1 became agitated and loud again and requested staff to assist with sending C-1 to the hospital for medical services. C-1 was taken to Los Angeles Community Hospital for treatment of a medical condition and mental health services. er Administrator, L.A. Community Hospital contacted Administrator at approximately 11 P.M. as C-1 refused treatment. Per Administrator, on 06/14/23 at approximately 2:30 AM, C-1 was transported back to this facility via ambulance. Per Administrator, C-1 refused to enter this facility and stayed outside in the driveway. Per Administrator, C-1 was not illegally evicted, has not been issued any eviction notices and remains as a client at this facility. LPA attempted to interview C-1 at this facility and was unable to interview as C-1 was agitated and yelling.

Based on record review and interviews conducted the findings indicate, although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation(s) are UNSUBSTANTIATED.

An exit interview conducted, appeal rights and a copy of this report was provided to Patria Dufrenne (Administrator).

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

LIC9099 (FAS) - (06/04)

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