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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306001396
Report Date: 03/06/2024
Date Signed: 03/06/2024 09:31:35 AM

Substantiated


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
12/11/2023 and conducted by Evaluator Alvaro Ramirez Jr.
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231211135300
FACILITY NAME:ALEXA'S HOMEFACILITY NUMBER:
306001396
ADMINISTRATOR:PATRICIA FESTINFACILITY TYPE:
735
ADDRESS:3117 W. CUBBONTELEPHONE:
(657) 245-3165
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:6CENSUS: 4DATE:
03/06/2024
UNANNOUNCEDTIME BEGAN:
08:26 AM
MET WITH:Patricia Festin-AdministratorTIME COMPLETED:
09:47 AM
ALLEGATION(S):
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Licensee is commingling personal funds with clients’ Personal and Incidental (P&I) funds
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alvaro Ramirez, Jr. conducted an unannounced visit to deliver findings on the above allegation received on 12/11/23. LPA was greeted and granted entry into the facility and met with Administrator (AD) Patricia Festin. LPA explained the reason for the visit.

This agency has investigated the complaint alleging that Licensee is commingling personal funds with clients’ Personal and Incidental (P&I) Funds. LPA Ramirez conducted file reviews and interviews and obtained copies of pertinent documents. Regarding the allegation, the following was revealed: During the investigation LPA reviewed documents including the Physician Reports (LIC602A) for Client 1 (C1) dated 03/29/23, for C2 dated 03/14/23 and for C3 dated 03/29/23. Per Physician Report C1, C2 and C3 are not able to manage own cash resources. During the initial visit on 12/20/23 LPA observed as AD counted the P&I Funds for C3, the total balance was $2,661.41. Records reviewed by LPA Ramirez included the Record of Client’s Safeguarded Cash Resources dated 09/30/23-12/26/23 for C3.
CONTINUED ON LIC9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
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 3
Control Number 22-AS-20231211135300
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: ALEXA'S HOME
FACILITY NUMBER: 306001396
VISIT DATE: 03/06/2024
NARRATIVE
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Per Record of Client’s Safeguarded Cash Resources for C3 on 12/20/23 C3 had a balance of $2,368.63. During the course of the interviews, AD stated that she lets the clients borrow money and then gets reimbursed from the clients’ P&I Funds. During the course of the interviews with clients C1 reported that the owner lets him borrow money. Per AD C1, C2 and C3 share a Client Trust Account. Documents reviewed included the California Bank Trust statement dated 01/19/24-02/20/24 for C3. Per bank statement the ending balance for C3 on 02/02/24 was $2,747.82. Per Record of Client’s Safeguarded Cash Resources for C3 on 02/02/24 C3 had a balance of $1,732.94.

Based on the interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the following allegation: Licensee is commingling personal funds with clients’ Personal and Incidental (P&I) Funds is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D.



An exit interview was conducted with AD Festin and a copy of this report along with the Appeal Rights were provided at the time of this visit.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20231211135300
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: ALEXA'S HOME
FACILITY NUMBER: 306001396
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2024
Section Cited
CCR
80026(e)
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80026 Safeguards for Cash Resources, Personal Property, and Valuables of Residents (e) Cash resources, personal property, and valuables of clients shall be separate and intact, and shall not be commingled with facility funds or petty cash. This requirement is not met as evidence by:
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Licensee will submit a written plan on how to ensure the P&I ledger is balanced at all times and matches the facility ledger and bank statement. Licensee to forward proof to LPA by POC due date.
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Based on records reviewed the bank statement for C3 does not match the balance on the Record of Client’s Safeguarded Cash Resources dated 02/02/24 for C3.
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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: Sheila Santos
LICENSING EVALUATOR NAME: Alvaro Ramirez Jr.
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3