306002286-6-16-2023-22-AS-SSAS-CT6UNJ-20230626154400

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306002286
Report Date: 06/16/2023
Date Signed: 06/16/2023 12:19:07 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
03/27/2023 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230327134042

FACILITY NAME:	R & R CARE, INC.		FACILITY NUMBER:	306002286
ADMINISTRATOR:	ROMAN MATAGA		FACILITY TYPE:	740
ADDRESS:	14952 BURNHAM CIRCLE		TELEPHONE:	(949) 651-1830
CITY:	IRVINE	STATE: CA	ZIP CODE:	92604
CAPACITY:	6	CENSUS: 6	DATE:	06/16/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Roman Mataga, administrator		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

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Staff handles resident in a rough manner.

Staff yells at resident in care.

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the two allegations listed above. LPA was greeted and granted entry by caregiving staff after explaining the reason for the visit. Administrator Roman Mataga was notified of the visit via telephone and arrived later to assist.

An initial complaint investigation visit was coducted on March 29, 2023. LPA accompanied with caregiving staff toured the physical plant. LPA requested and reviewed staff records and confirmed the identity of caregiving staff currently providing care and supervision at the facility. LPA conducted interviews with staff members S1 and S2 as well as with the facility administrator. One resident interview was conducted as well.

A follow-up unannounced visit was held on June 15, 2023. LPA toured the physical plant again and interviewed two staff members. Interviews were held or attempted with all six individuals in care at the time of the visit. CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2023

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-20230327134042

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: R & R CARE, INC.	FACILITY NUMBER: 306002286
	VISIT DATE: 06/16/2023

NARRATIVE

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CONTINUED FROM FORM LIC9099

Additional interviews with multiple responsible parties and witnesses were conducted in person or by telephone.

Regarding the allegation that Staff handles resident in a rough manner, the following has been concluded: Based on observation along with interviews with staff, residents, responsible parties and witnesses, the majority of the evidence gathered cannot confirm that any staff members are conducting inappropriate or rough handling of residents during assistance with the activities of daily living or when conducting transfers. Therefore the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Regarding the allegation that Staff yells at resident in care, the following has been concluded: Based on multiple observations led at the facility along with interviews with staff, residents, responsible parties and witnesses, the majority of the evidence collected does not corroborate that inappropriate verbal interactions or yelling are occurring at the facility. As a result, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of this report was provided to facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2023

LIC9099 (FAS) - (06/04)

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