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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005362
Report Date: 04/27/2023
Date Signed: 04/27/2023 11:09:25 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
01/17/2023 and conducted by Evaluator Celine DePerio
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230117155902
FACILITY NAME:LP CARE HOMEFACILITY NUMBER:
306005362
ADMINISTRATOR:TRAN, LINDAFACILITY TYPE:
735
ADDRESS:8791 MONTEREY CIRCLETELEPHONE:
(714) 622-5764
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:6CENSUS: 5DATE:
04/27/2023
UNANNOUNCEDTIME BEGAN:
09:19 AM
MET WITH:House Manager - Marie Voelker TIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Facility mishandled client's finances
Facility failed to retain proper record of client's funds
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Celine De Perio conducted an unannounced visit to the facility to deliver the findings for the complaint received on 1/17/23. LPA was greeted and granted entry by house manager (HM) Marie Voelker and explained reason for visit. For today's visit there are a total of 5 clients in care and 1 staff member on duty.

This department has investigated the complaint alleging that facility mishandled client's finances.
LPA conducted a total of 6 interviews which consisted of staff, clients and family members. 6 out of the interviews conducted stated that there were "no concerns" regarding facility handling client's finances due to facility constantly keeping track of finances and remaining in communication with Social Security. 3 out of the interviews conducted stated that updates with Social Security are conducted via phone call, of which then is relayed to Regional Center.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
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 2
Control Number 22-AS-20230117155902
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: LP CARE HOME
FACILITY NUMBER: 306005362
VISIT DATE: 04/27/2023
NARRATIVE
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 LPA reviewed the following documents such as but not limited to: LIC500, client roster, client (C1) social security updates between the dates of October 2022-December 2022, financial documents for C1 such as: bank statements and transactions, and care plan, physician report, needs and services plan, incident reports, progress notes, medical history regarding C1.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

This department has investigated the complaint alleging that facility failed to retain proper record of client's funds. LPA conducted a total of 6 interviews which consisted of staff, clients and family members. 3 out of the interviews conducted did not corroborate with the allegation, of which the 3 interviews stated that the facility has a designated binder that keeps track of client funds such as: transactions and receipts, and facility administrator has copies of each financial statements per client. LPA reviewed the following documents such as but not limited to: LIC500, client roster, client (C1) social security updates between the dates of October 2022-December 2022, financial documents for C1 such as: bank statements, transactions, receipts, purchases and transactions.

Based on the information gathered during the investigation and review of documents obtained, LPA is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED.

For today's visit, no citation was issued.

An exit interview was conducted with HM and a copy of this report was provided and explained to HM.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Celine DePerio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2