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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300605409
Report Date: 02/10/2023
Date Signed: 02/10/2023 03:25:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2022 and conducted by Evaluator Andrea Mendivil
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20221108152607
FACILITY NAME:SUTTON FOUNDATIONFACILITY NUMBER:
300605409
ADMINISTRATOR:JORGE G. MONROYFACILITY TYPE:
735
ADDRESS:4101 BELVEDERETELEPHONE:
(949) 651-0778
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:6CENSUS: 6DATE:
02/10/2023
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Jorge Gonzalez -Administrator TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Insufficent staff to client ratio
INVESTIGATION FINDINGS:
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On this day Licensing Program Analysts (LPAs) Andrea Mendivil and Alvaro Ramirez made an unannounced visit to deliver findings. LPAs were greeted and granted entry to the facility by Administrator Jorge Gonzalez and discussed the findings for the allegation above.

The department received a complaint on 11/08//2022 and the department made an intiail visit on 11/18/2022. During the course of the investigation, the Department interviewed staff and attempted to interview clients. In addition the department obtained copies of staff schedules, payroll documents and client information. Regarding the allegation that there is insufficent staff to client ratio, the investigation revealed the following:

It was alleged by a witness that there was only 1 staff for 6 clients on 11/01/2022. Based on timesheets provided by the facility only 2 staff members were scheduled during the times of 7am-12pm. Based on interviews with staff, Staff 1 (S1) left the facility while on lunch leaving Staff 2 (S2) with a total of 4 clients.
CONT on 9099-C dated 02/10/2023
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023
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 3
Control Number 22-AS-20221108152607
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: SUTTON FOUNDATION
FACILITY NUMBER: 300605409
VISIT DATE: 02/10/2023
NARRATIVE
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Per interviews with staff, Client 1 (C1) was out of the facility with family and Client 2 (C2) was at school.

Therefore based on the preponderance of evidence through interviews the allegation that facility has insufficient staff to client ratio is SUBSTANTIATED, meaning the complaint allegation was valid and that a violation has occurred.

The following is being cited per California Code of Regulations Title 22 Division 6 Chapter 8.

An exit interview was conducted and a copy of this report and appeal rights was provided to the Administrator.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20221108152607
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: SUTTON FOUNDATION
FACILITY NUMBER: 300605409
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/20/2023
Section Cited
CCR
85065.5(a)(1)
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Day Staff- Client Ratio
(a) Whenever a client who relies upon others to perform all activities of daily living is present, the following minimum staffing requirements shall be met:(1) For Regional Center clients, staffing shall be maintained as specified by the Regional Center but no less than one direct care staff to three such clients.
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Administrator indicated is in the process of hiring new staff. Administrator to provide updated LIC 500 and pending new hire schedule to CCLD by POC.
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This was not met as evidence by on 11/01/2022 1 staff was left with 4 clients, this poses a potential health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3