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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306003757
Report Date: 01/19/2024
Date Signed: 01/19/2024 10:11:13 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2022 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220613145720
FACILITY NAME:MILLS CARE HOMEFACILITY NUMBER:
306003757
ADMINISTRATOR:RAFAEL TORRESFACILITY TYPE:
735
ADDRESS:9737 MILLS AVENUETELEPHONE:
(562) 945-6416
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY:4CENSUS: 3DATE:
01/19/2024
UNANNOUNCEDTIME BEGAN:
08:56 AM
MET WITH:EdwIn Teoco, DSPTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff inappropriately touched a resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint visit to deliver findings on th above allegation that was investigated by DSS/CCLD Investigations Branch (IB) Investigator Philippe Miles. The purpose of the visit was explained to DSP staff Edwin Teoco. Assistant Administrator was explained the purpose of the visit and was read the report telephonically.

The investigation consisted of: On 6/15/2022, LPA Galarza conducted a health and safety check that included a physical plant inspection, and resident and staff file review. The following documents were obtained: Face Sheet, Physician Report, Regional Center IPP, day program information, incident report dated 6/12/22, LA Co. Sheriff's report #, ER Summary of Care, June 2022 Medication Administration Record (MAR), Personnel Record of staff (S1-S4),resident roster and LIC 500 Personnel Report. Investigations Branch obtained medical and forensic records. NOTE: The Eastern Los Angeles Regional Center (ELARC) was notified of the incident. However, ELARC did not follow-up on the incident, nor conduct an investigation. Therefore, a Corrective Action Report was not issued.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024
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 28-AS-20220613145720
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: MILLS CARE HOME
FACILITY NUMBER: 306003757
VISIT DATE: 01/19/2024
NARRATIVE
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Allegation: Staff inappropriately touched resident. It is alleged that on 6/12/2022 at approximately 1315 hours, after lunch, staff (S1) put it's arms around resident (R1) from behind, and proceeded to touch resident (R1's) breasts and genitalia while the resident was in the kitchen/dining area. Department of Social Services Investigations Branch (IB) Investigator P. Miles conducted the investigation. Based on interviews conducted, the findings indicate that staff (S1) sexually abused the developmentally disabled resident by touching R1's genitalia, and grabbing of upper body area. The perpetrator staff stated that the resident felt good when they were touched. The victim (R1) asked staff (S1) to stop, but staff (S1) refused. The alleged incident lasted approximately five (5) minutes, and was interrupted by a phone call received by the staff. There were no witnesses. Other residents were in the living room watching television when the incident occurred.

On 6/12/2022, LA County Sheriff's Department personnel conducted a health and welfare check. They offered to take the resident for a medical exam, but the resident refused. The following day, Assistant Administrator Jacqueline Mikin transported R1 to the hospital for a Forensic Medical Report: Acute Adult/Adolescent Sexual Assault Examination. Evidence was collected. On 6/15/2022, LPA conducted a health and safety check and observed staff (S1's) personal belongings in the staff room. Criminal record clearance was checked and staff (S1) was not associated to the facility. Staff (S1) was hired on 5/6/2022.

During the interview, staff (S1) claimed numerous times that they did not touch the resident. However, staff (S1) finally admitted to touching the resident inappropriately, and stated it was "an accident and mistake". On 1/12/2024, LPA called other licensed facilities where staff (S1) is associated. Staff (S1) answered the phone at an Orange County licensed facility owned by the same licensee. Staff (S1) confirmed their identity. Therefore, staff (S1) is still employed at Licensee's other home. There is an indication that the licensee was not being forthcoming about whether staff (S1) continues to work in a licensed facility since they did not disclose that they were employed at an associated facility. Sufficient evidence exists to immediately exclude staff member, and corroborate the allegation.

An immediate civil penalty of $500.00 is hereby assessed (Refer to LIC 421B).

Administrator was informed that an enhanced civil penalty might be assessed based on H & S Code.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Per Title 22, deficiencies are cited.

This report was reviewed telephonically with Assistant Administrator Jacqueline Mikin. A copy of the report, appeal rights, and civil penalty assessed was provided to staff Edwin Teoco.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20220613145720
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: MILLS CARE HOME
FACILITY NUMBER: 306003757
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/20/2024
Section Cited
CCR
80072(a)(3)
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Personal Rights. To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Licensee/Administrator shall conduct staff in-service training with all staff on regulation 80072 (a)(3), and mandated Report of Suspected Dependent Adult/Elder Abuse reporting requirements. Submit training log + training procedures to CCLD as proof of correction by POC due date.
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This requirement was not met evidenced by:
Based on Investigations Branch (IB) findings, on 6/12/2022 DSP staff (S1) sexually abused and threatened resident (R1) causing harm to the developmentally disabled adult. This posed an immediate health, safety, or personal rights risk to persons 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.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3