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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005402
Report Date: 04/20/2023
Date Signed: 04/20/2023 02:31:39 PM

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
04/19/2023 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230419125848
FACILITY NAME:ENDEAVORS RESIDENTIAL CAREFACILITY NUMBER:
306005402
ADMINISTRATOR:PENALOSA, BRANDONFACILITY TYPE:
735
ADDRESS:9301 BIXBY AVENUETELEPHONE:
(310) 938-0700
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY:4CENSUS: 4DATE:
04/20/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Brandon Penalosa, AdministratorTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
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9
Personnel File not available for a staff member

Client Personal & Incidental funds records not available for review
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting an initial investigation into the allegations listed above. At approximately 11:00am, LPA attempted to ring the doorbell and knocked on the door with no response. LPA called licensee and left a voicemail.

LPA returned to the facility at approximately 1pm and was greeted and granted entry by caregiving staff after introducing himself and stating the purpose of the visit. Facility administrator Brandon Penalosa spoke with LPA via telephone and arrived later to assist with the visit.

All clients are observed to be away at day program and stated by caregiver John Serrano to be scheduled to come back to the facility at approximately 2pm. LPA accompanied by caregiver conducted a tour of the facility.

CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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-20230419125848
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: ENDEAVORS RESIDENTIAL CARE
FACILITY NUMBER: 306005402
VISIT DATE: 04/20/2023
NARRATIVE
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CONTINUED FROM FORM LIC9099

LPA requested, obtained and reviewed client records along with personnel files maintained at the facility.

Regarding the allegation that Personnel File not available for a staff member, the following was concluded: Based on a review of the personnel records at the facility, LPA was able to observe that records are complete and include all necessary component for all staff members on the roster. Staff member S1's records were reviewed at the facility and are complete also. Staff member is adequately cleared and associated to the facility. Based on records reviewed, the allegation is therefore found 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.

Regarding the allegation that Client Personal & Incidental funds records not available for review, the following was concluded: Personal and Incidental Funds records were observed to be present, cash on hand was also observed by LPA to be present and accurate. Monthly balances for the month of April have not yet been finalized however ledgers were found to be up-to-date and present until the month of March 2023. Facility administrator stated that the ledgers were temporarily kept off site during a period of leave for the house manager out of an abundance of caution but that they have been relocated back to the facility at the time of the present visit. As a result, based on the records reviewed and interview conducted, the allegation is found 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 was conducted and a copy of this report was provided to the facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2