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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603665
Report Date: 08/20/2024
Date Signed: 08/20/2024 03:35:21 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
08/19/2024 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240819100904
FACILITY NAME:PRISTINE CARE 1FACILITY NUMBER:
198603665
ADMINISTRATOR:VANKINA, VENKATESWARAFACILITY TYPE:
735
ADDRESS:14639 DALMATIAN AVETELEPHONE:
(720) 272-7437
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY:4CENSUS: 3DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
11:02 AM
MET WITH:Venkat Vankina - AdministratorTIME COMPLETED:
03:58 PM
ALLEGATION(S):
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Staff is sexually abusing clients in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced complaint visit to address the allegation listed above. LPA met with Venkat Vankina, Administrator for the facility, and explained the purpose of the visit.

The investigation consisted of the following: During the visit, LPA interviewed Clients #1 - 3 (C1 - C3), Staff #1 - 4 (S1 - S4), Witnesses #1 - 2 (W1 - W2), and also obtained copies of the facilitiies resident and clients roster, along with the Physician's Report, Individual Program Plan (IPP), and FACE Sheet for C1 - C2, and also reviewed individual client notes for C1.


The investigation revealed the following: In regards to the allegation that a "Staff is sexually abusing clients in care," it is alleged that S1 had been sexually abusing C1 and C2 by intentionally looking at them in an inappropriate manner, such as when they are undressing in their room or nude.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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 2
Control Number 28-AS-20240819100904
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: PRISTINE CARE 1
FACILITY NUMBER: 198603665
VISIT DATE: 08/20/2024
NARRATIVE
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During interviews with the clients, none of them corroborated the allegation that S1 has been intentionally looking at C1 or C2 in an inappropriate manner. One of the clients interviewed stated that C1 often takes off their clothing when they are having a tantrum, and that everyone is able to see them when they are however the client stated that they no one including S1 is intentionally looking at them in an inappropriate manner. During interviews with the staff, none of them corroborated the allegation that S1 looks at C1 and C2 in an inappropriate manner. One of the staff interviewed stated that C1 frequently takes their top off in the kitchen when they are upset in order to get attention, however during these instances S1 never intentionally looks at C1 inappropriately. Another staff member confirmed that C1 at times removes their clothing when having emotional outbursts, and additionally that they have never witnessed S1 intentionally looking at C2 inappropriately either. LPA interviewed W1 who confirmed that one of their behaviors does include taking off their clothes when they have a tantrum. During record review of C1's IPP, it was revealed that in their previous home they frequently walked around the house nude.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. 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.

Exit interview held, and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2