<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005362
Report Date: 08/30/2024
Date Signed: 08/30/2024 04:22:31 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
12/24/2020 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20201224095549
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: 2DATE:
08/30/2024
UNANNOUNCEDTIME BEGAN:
01:32 PM
MET WITH:Phil TranTIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Medication errors resulting in client having seizures
Political party signs being posted in facility yard
Staff are placing phone calls on speaker phone without caller consent in front of clients
Staff are urging clients not to get vaccinated

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings for the complaint investigation into the allegations listed above. LPA met with Administrator Phil Tran and explained the reason for the visit. The investigation into the allegation, medication errors resulting in client having seizures revealed the following. Client 1 (C1) had a seizure on February 26, 2020. C1 was taken to the emergency room and treated. It was reported that the change from Carbatrol to the generic form Carbamazepine was the cause of the seizures. The medication logs for Client 1 (C1) from January 2020 through April 2020 were reviewed. The prescription dated August 2, 2019, state, “Carbatrol 200 mg (Brand) 3 pills”. On January 23, 2020, the pharmacy changed Carbatrol 200 mg for the generic form Carbamazepine 200 mg. It is unclear why the pharmacy changed to the generic medication. On February 26, 2020, after C1 had been treated by the hospital, C1’s physician wrote a new prescription which stated, “Go back on Carbatrol 200 mg”. The medication logs indicate Carbamazepine was discontinued on February 27, 2020. The medication logs indicate the facility administered medications as prescribed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
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 6
Control Number 22-AS-20201224095549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: LP CARE HOME
FACILITY NUMBER: 306005362
VISIT DATE: 08/30/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The facility is not responsible for the pharmacy changing medication to a generic form and had no way of knowing if it would affect C1. Based on the evidence gathered the allegation is deemed unsubstantiated, meaning although the allegations may have happened or may be valid; there is not a preponderance of evidence to prove that the alleged violation occurred.

The investigation into the allegation, political party signs being posted in the facility yard, revealed the following. Staff 1 reported that clients were not urged to put up any signs and the clients came up with the idea to put up signs in the front yard. 4 out of 5 clients interviewed reported they wanted to put up signs in the front yard. C1 was interviewed again on April 12, 2024 and they did not mention anything about the signs. Based on the evidence gathered the allegation is deemed unsubstantiated, meaning although the allegations may have happened or may be valid; there is not a preponderance of evidence to prove that the alleged violation occurred.

The investigation into the allegation, staff are placing phone calls on speaker phone without caller consent in front of clients, revealed the following. 4 out of 5 clients interviewed reported that the facility provides privacy to each client and denied that the staff placed their calls on speaker phone without consent. 3 out of the 5 clients interviewed, reported that if phone calls are put on speaker, it’s because they decided to put the call on speaker phone. C1 reported that Staff 1 would listen in on their calls without consent, Staff 1 denied this report. Based on the evidence gathered the allegation is deemed unsubstantiated, meaning although the allegations may have happened or may be valid; there is not a preponderance of evidence to prove that the alleged violation occurred.

The investigation into the allegation, staff are urging clients not to get vaccinated, revealed the following. 4 out of 5 clients interviewed reported that the facility staff asked each client if they wanted to get vaccinated. 4 out of 5 clients interviewed verified that the facility gave each client a choice whether to get vaccinated or not. C1 was interviewed on April 12, 2024. C1 did not report anything about vaccinations. Based on the evidence gathered the allegation is deemed unsubstantiated, meaning although the allegations may have happened or may be valid; there is not a preponderance of evidence to prove that the alleged violation occurred.

An exit interview was conducted and a copy of the report provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
12/24/2020 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20201224095549

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: 2DATE:
08/30/2024
UNANNOUNCEDTIME BEGAN:
01:32 PM
MET WITH:Phil TranTIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility failed to report COVID-19 cases
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings for the complaint investigation into the allegation listed above. LPA met with Administrator Phil Tran and explained the reason for the visit. The investigation into the allegation, facility failed to report Covid-19 cases, revealed the following. 5 out of 5 witnesses interviewed reported that facility staff informed the client’s responsible parties if clients tested positive for Covid-19. 2 out of 2 interviews conducted with client’s responsible parties verified that the facility notified the families of Covid-19 positive cases. On May 13, 2022, the Department received a report from the Regional Center of Orange County (RCOC) that C1’s family member had tested positive for Covid-19 and C1 had been exposed. According to the report C1’s family member expected C1 to be isolated but according to C1’s family member the facility took no action. C1’s family member shared and provided a photo of a positive test result for C1 from May 8, 2022. On August 1 , 2022, the Department received a report that C1 had tested positive for Covid-19 on July 28, 2022. It cannot be determined how many times C1 had Covid-19.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
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 6
Control Number 22-AS-20201224095549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: LP CARE HOME
FACILITY NUMBER: 306005362
VISIT DATE: 08/30/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
A review of records shows only 1 reported case of Covid-19 for C1. The facility cannot verify that they tested the clients for Covid-19 in May 2022 and did not report any positive Covid-19 cases to the Department until August 2022. Due to the State Emergency at that time facilities were required report individual Covid-19 cases to the Department. C1 tested positive for Covid-19 on or around May 8. 2022 and the facility was notified by C1’s family member but the facility did not report this information to the Department. Based on the evidence gathered the preponderance of evidence standard has been met, therefore the allegation is substantiated.

Deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interviewed was conducted and a copy of the report along with appeal rights was provided.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 22-AS-20201224095549
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: LP CARE HOME
FACILITY NUMBER: 306005362
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/03/2024
Section Cited
CCR
80061(b)(1)(E)
1
2
3
4
5
6
7
(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below, a report shall be made to the licensing agency... (E) Any unusual incident or client absence which threatens the physical or emotional health or safety of any client.
1
2
3
4
5
6
7
Licensee agrees to report all incidents in compliance with the CCR 80061. Administrator to submit a signed statement attesting to their understanding of CCR 80061 and to provide it to the LPA by the POC due date.
8
9
10
11
12
13
14
This requiirement was not met as evidenced by, C1 tested positive for Covid-19 and the facility did not report it to the Department.
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.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6