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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306001378
Report Date: 02/13/2024
Date Signed: 02/13/2024 03:02:21 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
03/01/2023 and conducted by Evaluator Jenifer Tirre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230301105554
FACILITY NAME:CATHERINE'S HOMES, INC. (JEFFERSON AVE)FACILITY NUMBER:
306001378
ADMINISTRATOR:ASUNCION GONZALESFACILITY TYPE:
735
ADDRESS:518 S. JEFFERSON AVENUETELEPHONE:
(714) 992-6774
CITY:FULLERTONSTATE: CAZIP CODE:
92832
CAPACITY:6CENSUS: 6DATE:
02/13/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator/ Licensee, Michael San DiegoTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Facility is threatening client
Facility is violating client's personal rights
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jenifer Tirre made a unannounced visit and met with Administrator Michael San Diego to discuss the finding for the above allegations. The investigation consisted of interviews with staff, clients and Regional Center Staff. The investigation also consisted of reviewed documentation such as Regional Center of Orange County Individual Program Plan, Physician’s Report, and Facility House Rules. The Investigation revealed the following:

On 3/1/2023 the department received allegations that Facility is threatening client and Facility is violating client’s personal rights. Per interviews conducted with staff, three of three staff interviewed confirmed that to their knowledge staff have not threatened or violated a client’s personal rights. Facility Records reveal that facility has conducted in service trainings for Mandated Reporting, Personal Rights and Infection control trainings have been completed on 2/8/23, 5/1/23 and 1/17/24. Interviews with clients revealed that three of three clients confirm that they have no issues or concerns with staff, clients received meals & medications and clients allowed to go out to day program and outings.
CONTINUED ON 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024
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 22-AS-20230301105554
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: CATHERINE'S HOMES, INC. (JEFFERSON AVE)
FACILITY NUMBER: 306001378
VISIT DATE: 02/13/2024
NARRATIVE
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Client 1 confirmed they do not have any issues with staff and stated they have never been threatened by staff. Clients are allowed to use their money to purchase items they want including cigarettes. Staff interviews revealed that staff never told clients they couldn't smoke at facility but did mention they had to smoke in designated smoking area outside in back yard. C1 confirmed that when they smoke they do smoke outside in backyard area. Interview with witness confirmed that facility has designated area for smoking and that witness confirmed C1 does smoke in designated area and has been informed that they can not smoke inside of house. LPA observed that facility posted house rules state "Residents will smoke only at the designated area in the home".

Based off interviews, documents and observations, the allegations, facility is threatening client and Facility is violating client's personal rights are deemed UNSUBSTANTIATED. Although the allegations may have happened or is valid there is no preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted with Administrator and a copy of this report along with a LIC 811 was provided to facility.

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jenifer Tirre
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2