306001582-3-3-2023-22-AS-LADS-CPS2UZ-20230309164307

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306001582
Report Date: 03/03/2023
Date Signed: 03/03/2023 11:29:00 AM

Unsubstantiated

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
02/14/2023 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230214155733

FACILITY NAME:	PARAGON HOME		FACILITY NUMBER:	306001582
ADMINISTRATOR:	RENATO MADRIGAL		FACILITY TYPE:	735
ADDRESS:	2356 N BAILEY STREET		TELEPHONE:	(714) 283-0228
CITY:	ORANGE	STATE: CA	ZIP CODE:	92867
CAPACITY:	6	CENSUS: 3	DATE:	03/03/2023
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Renato Madrigal		TIME COMPLETED:	09:55 AM

ALLEGATION(S):

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Staff threatened to kick client out of the facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jerome Haley made an unannounced visit to deliver the findings on the complaint allegation above. LPA identified himself and explained the purpose of the visit with staff. Upon entry, LPA Haley briefly toured the interior and exterior of facility with Licensee/Administrator (AD) Renato Madrigal. There were three clients present during the visit.

Regarding the complaint allegation, on February 15, 2023, LPA Haley made an unannounced visit to investigate the complaint allegation listed above. During the course of the investigation, LPA Haley interviewed Licensee/Administrator Madrigal, Staff 1 (S1), Client 1 (C1), Client 2 (C2), C1’s Responsible Party (RP) and a few Regional Center Staff who had knowledge of the complaint allegations.

Regarding the allegation, Staff threatened to kick client out of the facility:

Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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 22-AS-20230214155733

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: PARAGON HOME	FACILITY NUMBER: 306001582
	VISIT DATE: 03/03/2023

NARRATIVE

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During the investigation, LPA Haley discovered C1 has a history of elevating issues to his Responsible Party (RP) or the Regional Center before going to the Licensee/Administrator and/or facility staff to give them and opportunity to resolve the issue. It was discovered that C1 was told that he needs to start notifying the facility staff before elevating the matter, by more than one person. Further, C1 was in a meeting with another client in the facility who was causing a lot of disturbance in the facility and bullying other clients in the facility. During that meeting C2 was informed if his behavior doesn’t change, he would be given a 30-day notice. It’s believed that C1 may have got confused and scared and thought that he was getting a 30-day notice as well because he was in the same meeting. No evidence to support this allegation was provided, and there were no witnesses to confirm this allegation to be true.

Based on the information gathered during the investigation, review of all documents obtained, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.

An exit interview was conducted, and a copy of this report was provided AD Madrigal.

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC9099 (FAS) - (06/04)

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