306004460-4-26-2023-22-AS-SSAS-CRBNC8-20230428102018

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004460
Report Date: 04/26/2023
Date Signed: 04/26/2023 11:26:24 AM

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
04/14/2023 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230414141352

FACILITY NAME:	REAL HEARTS HOME		FACILITY NUMBER:	306004460
ADMINISTRATOR:	EVELYN SCHAEFER		FACILITY TYPE:	735
ADDRESS:	2860 W.COOLIDGE AVENUE		TELEPHONE:	(714) 886-2076
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	6	CENSUS: 5	DATE:	04/26/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Ronald Manalad, administrator (via telephone)		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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9

Staff not providing clients with a comfortable environment.

INVESTIGATION FINDINGS:

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13

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings in the investigation of the allegation listed above. LPA was greeted and granted entry by caregiving staff after explaining the purpose of the visit. Administrator Ronald Manalad was notified of the visit by telephone and agreed to review the findings before authorizing one of the caregivers to sign on his behalf.

An initial complaint investigation visit was conducted on April 19, 2023. LPA accompanied by caregiver toured the physical plant of the facility and reviewed the client records for all five clients in care. Interviews were conducted with caregiving staff as well as the administrator. Further interviews conducted via telephone after the completion of the initial visit.

CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

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-20230414141352

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: REAL HEARTS HOME	FACILITY NUMBER: 306004460
	VISIT DATE: 04/26/2023

NARRATIVE

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CONTINUED FROM FORM LIC9099

Regarding the allegation that Staff not providing clients with a comfortable environment, the following has been concluded:

Based on records reviewed for client C1, client is diagnosed with autism spectrum disorder. The behaviors described in the initial complaint report have been documented on multiple instances in the client's file and are consistent with ongoing assessment of the client's condition. Observation conducted during the initial visit along with additional interviews with Regional Center of Orange County staff confirmed that the observations in the initial report were consistent with the client's preferred activities and environment. Client was observed to be relaxed in his bedroom with background music playing at a comfortable volume throughout the initial visit. Multiple interviews corroborated that the client is additionally included in daily and weekly social outings but is generally most comfortable and displaying fewer disruptive behaviors when allowed to stay in his bedroom. Constant attention and supervision was observed to be provided as well.

Therefore, the allegation is deemed to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted with the facility administrator via telephone and a copy of this report was provided to a facility representative.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

LIC9099 (FAS) - (06/04)

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