306004099-4-7-2025-28-AS-DSIS-DFQTCM-20250414143654

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004099
Report Date: 04/07/2025
Date Signed: 04/07/2025 12:58:16 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
03/17/2025 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250317134547

FACILITY NAME:	ALEXANDER FAMILY HOME		FACILITY NUMBER:	306004099
ADMINISTRATOR:	HILEWNA TAMRAT		FACILITY TYPE:	735
ADDRESS:	13020 BONA VISTA LANE		TELEPHONE:	(562) 404-9673
CITY:	LA MIRADA	STATE: CA	ZIP CODE:	90638
CAPACITY:	4	CENSUS: 3	DATE:	04/07/2025
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Yvonne Alexander– Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff do not ensure resident's hygiene needs are met
Staff are not ensuring meals are of quality/quantity to meet the needs of the resident
Staff do not ensure resident had a mattress to sleep on

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to deliver findings on the above allegations. LPA was greeted by and met with Administrator Yvonne Alexander and the reason for the visit was explained.

The investigation consisted of the following:
During initial visit dated 3/27/25 LPA toured facility, observed food supply, checked hygiene products, 3 client rooms were toured, LPA interviewed 3 staff and 1 client, 2 clients could not communicate verbally but LPA was able to observe their hygiene visually, and LPA requested copies of staff and client rosters which were emailed to LPA on 4/1/25.
On todays visit LPA delivered findings.

(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025

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 28-AS-20250317134547

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ALEXANDER FAMILY HOME	FACILITY NUMBER: 306004099
	VISIT DATE: 04/07/2025

NARRATIVE

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The investigation revealed the following:
Allegation: Staff do not ensure resident's hygiene needs are met.
It is alleged that staff are not assisting C1 with shaving and cutting nails. LPA interviewed 3 staff and 3 out of 3 staff denied the above allegation, it was stated that S2 is who assists the clients with shaving, clipping of nails and haircuts. Per S2 clients are provided these services twice a month or as needed. LPA observed clients arriving from their day program during visit each client appeared well groomed with clean clothing. LPA observed each clients hands/nails and nails appeared to be well trimmed. Each client showered shortly after arrival, per their routine and this is noted on the schedule posted in facility. LPA interviewed C2, they denied the above allegation and stated that they see staff assisting the clients with showers, shaving and trimming of nails, C2 stated they are able to handle these hygiene needs on their own and do not require assistance. LPA observed each clients hygiene product basket that included all basic needs for proper hygiene.

Allegation: Staff are not ensuring meals are of quality/quantity to meet the needs of the resident.
It is alleged that C1 is not being provided full meal with protein and are limiting C1 to only rice and oatmeal. LPA interviewed 3 staff and 3 out of 3 staff denied the above allegation and stated the clients are provided with proper meals with proper nutrition, clients are able to make suggestions and decide what they would like for their meals. Interview with C2 revealed that clients are given sufficient food and with proper nutrition, 3 meals are provided daily and snacks are also available for clients. Interviews with C3-C4 were not successful as they could not communicate verbally. LPA reviewed food supply and facility appeared to have sufficient amount of food that includes, fruits, vegetables, breads, meats and dairy.

Allegation: Staff do not ensure resident had a mattress to sleep on.
It is alleged that C1 was sleeping on a wooden crate bed with no mattress. LPA interviewed 3 staff and 3 out of 3 staff denied the above allegation and stated that there has never been a time that the clients beds within the facility have gone without having a mattress. LPA interviewed C2 and client denied the allegation and stated they have never seen a client at the facility sleep on a wooden crate and all beds have proper mattress with bedding. LPA toured the 3 client bedrooms, each room was properly furnished, beds had mattresses and bedding. There is currently 1 bedroom that is vacant and room is fully furnished, with proper mattress and bedding.
(Continued on LIC9099-C)

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250317134547

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ALEXANDER FAMILY HOME	FACILITY NUMBER: 306004099
	VISIT DATE: 04/07/2025

NARRATIVE

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Due to C1 no longer being a client at the facility LPA was unable to speak or make any visual observations regarding C1.

Based on statements and interviews conducted with staff/clients, review of client files, and LPA’s observations. There was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025

LIC9099 (FAS) - (06/04)

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