198603634-11-9-2023-28-AS-RORN-CZDQ33-20240111104805

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603634
Report Date: 11/09/2023
Date Signed: 11/09/2023 01:29:03 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
11/03/2023 and conducted by Evaluator Christine Wong

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231103163613

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: 45	DATE:	11/09/2023
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Patria Dufrenne		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Illegal Eviction
Facility is not providing client's funds

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Wong conducted an “Initial 10-Day” visit to ascertain information pertaining to the above-mentioned allegation(s) and to establish the validity of the complaint. LPA met with Staff #1 House Manger Richard Tan who allowed entry into the facility and was later met by Administrator Patria Dufrenne who assisted with the visit.

The investigation consisted of the following: LPA interviewed the administrator, three staff (S1-S3) and four clients (C2-C4) and obtained the client's roster, and documents about Client#1 (C1) included: 30 days eviction notice dated on 09/19/23, Department of Mental Health (DMH) Exit/Relocation form, face sheet, daily progress notes dated on 10/05/23, preplacement appraial information, functional capability assessment, DHS/DMH move in confirmation, admission agreement, physician report and facility house rules.

See LIC 9099C for continuation

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023

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-20231103163613

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: 11/09/2023

NARRATIVE

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The investigation revealed of the following: Allegation#1 "Illegal Eviction" Administrator reported the facility had been given out a lot of verbal warnings and written notices to C1 and C1's case manager due to C1 violated the house rules including loud and profane language, turn on the radio for a maximum volume after 9pm and destruction property...etc in the past four months. The administrator reported they had been discussed with C1's case manager about C1's behaviors but C1 did not improve and continue to fail to comply with facility house rules. Therefore, the facility issued a 30 days eviction notice on 09/19/23 with C1's case manager presence and C1 was moved to another facility on 10/19/23. LPA interviewed clients and denied the allegation and reported facility never illegal evicted them. LPA interviewed staff and reported they tried their best to work with C1 but C1 never listened to the staff and kept violating the house rules.

Allegation#2 "Facility is not providing client's funds" LPA interviewed administrator and administrator confirmed the facility did receive C1's November P&I money but due to C1 is under Department of Health Services (DHS) and they instructed the administrator not to forward C1's November P&I money to client's new facility as C1's new facility will issue the payment (P&I) money for C1, otherwise the facility will be overpaid. LPA also confirmed with DHS and they instructed the facility administrator not to forward the November P&I money to C1's new facility but they indicated if C1 had any money left from the facility, the facility should give it back to C1. LPA reviewed C1's record of client's safeguard cash resources report and it show C1's current balance is $0.

Based on the documents reviewed, interview conducted with clients and staff, 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.

An exit interview was conducted with Administrator. A copy of this report along with the appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023

LIC9099 (FAS) - (06/04)

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