306004205-12-5-2023-28-AS-LHIS-CYEVR4-20231211153920

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004205
Report Date: 12/05/2023
Date Signed: 12/05/2023 03:59:21 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
11/07/2022 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221107114826

FACILITY NAME:	TOTAL CARE RESIDENTAL		FACILITY NUMBER:	306004205
ADMINISTRATOR:	NORLAN MACHADO		FACILITY TYPE:	735
ADDRESS:	20220 MAPES		TELEPHONE:	(562) 229-1999
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	4	CENSUS: 4	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	11:03 AM
MET WITH:	Norlan Machado and Mary Machado Administrator		TIME COMPLETED:	04:04 PM

ALLEGATION(S):

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Staff had inappropriate sexual interaction with client.
Staff is mismanaging resident's P & I monies.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alberto Lopez conducted a subsequent complaint visit in response to the allegations listed above. LPA met with Erika Fregoso, Caregiver, Julie Machado, Manager and Administrator; Mary Machado arrived a short time later.

LPA interviewed 4 staff S#1-#5 (S1-S5), 2 witnesses (W#1-W#2 (W1-W2) and 4 clients C#1- C#4 (C1-C4) LPA reviewed and obtained copies of staff and resident rosters. LPA reviewed P&I ledgers and they did not appear to have any discrepancy at the time of visit.

Allegation: Staff had inappropriate sexual interaction with client. It is alleged that staff had sexual relations with unknown person/client at facility.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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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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
11/07/2022 and conducted by Evaluator Alberto Lopez

COMPLAINT CONTROL NUMBER: 28-AS-20221107114826

FACILITY NAME:	TOTAL CARE RESIDENTAL		FACILITY NUMBER:	306004205
ADMINISTRATOR:	NORLAN MACHADO		FACILITY TYPE:	735
ADDRESS:	20220 MAPES		TELEPHONE:	(562) 229-1999
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	4	CENSUS: 4	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	11:03 AM
MET WITH:	Norlan Machado and Mary Machado Administrator		TIME COMPLETED:	04:04 PM

ALLEGATION(S):

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Staff did not report incident.

INVESTIGATION FINDINGS:

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Allegation: Staff did not report incident. It is alleged that facility did not report the incident that client’s money was stolen and not reported to CCLD. Administrator stated to that one staff was terminated due to yelling at other staff and that same former staff “fed” negative ideas to resident. Administrator stated that petty cash was short but did not know how the shortage occurred. Administrator stated that none of the client's money was stolen. Facility has the responsibility to report any incident that may pose a safety hazard to client’s in care. Facility failed to report petty cash shortage (theft) and incident that happened in the summer of 2022 where former staff “fed” negative ideas to client in care.

Based on LPAs observations and interviews which were conducted, record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. Deficiencies are being cited on the attached LIC 9099D.

Substantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 28-AS-20221107114826

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: TOTAL CARE RESIDENTAL	FACILITY NUMBER: 306004205
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/05/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/08/2023 Section Cited CCR 80061(b)1)(e)	1 2 3 4 5 6 7	80061 Reporting Requirements (b) (1) below, a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in (2) below shall be submitted to the licensing agency within seven days following the occurrence of such event.	1 2 3 4 5 6 7	Administrator will read section 80061 (b)(1)(e) and send a written plan on how this will be corrected by POC date. Administrator will also send the two incident reports.
	8 9 10 11 12 13 14	(1) Events reported shall include the following: (E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client. The requirement was not met as evidenced by: Administrator told LPA that a former staff "fed" negative ideas to clients in care and there was also an incident that resulted in facility monies missing that were not reported which pose/posses a health and safety hazard to client's in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20221107114826

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: TOTAL CARE RESIDENTAL	FACILITY NUMBER: 306004205
	VISIT DATE: 12/05/2023

NARRATIVE

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The investigation reveal:

The department’s investigative branch investigated this allegation and did not have evidence to substantiate. Staff denied the allegation. 2 clients stated they were not sure but stated they did not witness any inappropriate sexual interactions between staff and other person.. Regional Center investigated the allegation and it was UNSUBSTANTIATED. There is not enough evidence to substantiate this allegation.

Allegation: Staff is mismanaging resident's P & I monies. It is alleged that facility had clients’ P&I money stolen. Staff interviewed all stated that P&I monies are not kept at facility. Administrator stated that some “facility money, petty cash” is kept at the home and that money is provided to residents when they request it, and it is then deducted on the client’s ledger to keep track of the balance. Administrator stated that the facility petty cash was short one time but could not identify the cause of the shortage. LPA review of the ledger for client’s P&I money and all receipts where in order. 3 of 4 client’s stated they get their P&I money. There is not enough evidence to substantiate this allegation.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED.
Exit interview conducted with Mary Machado, Administrator and a copy of this report is being provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

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