198603658-1-14-2025-28-AS-RORN-DD6PTG-20250122103555

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603658
Report Date: 01/14/2025
Date Signed: 01/14/2025 03:03:41 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
01/06/2025 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250106082738

FACILITY NAME:	DIGNITY HOME CENTER INC		FACILITY NUMBER:	198603658
ADMINISTRATOR:	DUROMOLA, ADEBOWALE EVELYN		FACILITY TYPE:	735
ADDRESS:	230 E BENWOOD ST		TELEPHONE:	(626) 922-3944
CITY:	COVINA	STATE: CA	ZIP CODE:	91722
CAPACITY:	6	CENSUS: 6	DATE:	01/14/2025
		UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Adebowale Duromola, Administrator		TIME COMPLETED:	03:13 PM

ALLEGATION(S):

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Staff twist resident's arm.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Vaid conducted an Initial 10-Day complaint investigation regarding the above allegation. LPA was greeted by Molly Okebode and Patience Oyesile and LPA discussed the purpose if the visit. Administrator arrived a short time later and assisted with visit.

Investigation consisted of the following: interview of Staff #1 - Staff #3 (S1-S3); interviews of clients from client#1 through client #6 (C1-C6); requested, obtained and reviewed client #1 (C1) face sheet, IPP dated 05/31/2023. LPA obtained copies of the staff and client rosters. LPA conducted a facility tour and did not observe any health and safety concerns.

The investigation revealed the following: Regarding the allegation: Staff twist resident's arm. It is alleged that S3 twisted C1’s arm, causing C1 to get bandages on her arm. LPA interviewed two (2) staff including administrator and all three (3) staff denied the allegation.
Continued 9099C......

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

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-20250106082738

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: DIGNITY HOME CENTER INC	FACILITY NUMBER: 198603658
	VISIT DATE: 01/14/2025

NARRATIVE

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LPA interviewed six (6) clients at their day programs via cellphone and five (5) of six (6) clients interviewed via cellphone could not collaborate the allegations.
C1 has a history of attention seeking behaviors, including fibbing and fabricating events, and it is documented in C1 last IPP by Regional Center, dated 05/31/2023. Telephone interviews with San Gabriel Pomona Regional Center service coordinator and quality assurance persons have confirmed C1 behaviors of fabrication and false allegations. Service coordinator also states that C1 has issues with facility administrator and has fabricated and made false accusations against the administrator in the past. Complaints have been investigated and regional center has dismissed the allegations due to inconsistent stories and behaviors by C1. S3 denied twisting C1’s arm, and S3 stated, they have never harmed a client.

There is not enough evidence to substantiate this allegation, therefore. Based on the information obtained during the investigation, interviews with regional center service coordinators, facility staff, and clients, review of client files and LPA's observations, the investigation did not reveal any evidence to support the allegation mentioned above.
Although the allegations may have happened or are valid, there is not preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegation is UNSUBSTANTIATED.
Exit interview conducted with Adebowale Duromola, administrator, and copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

LIC9099 (FAS) - (06/04)

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