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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005442
Report Date: 01/18/2024
Date Signed: 01/18/2024 12:20:55 PM

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
06/23/2022 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220623134733
FACILITY NAME:EASTERSEALS SOUTHERN CALIFORNIA - COUNTRY HILLSFACILITY NUMBER:
306005442
ADMINISTRATOR:DANIELA R. TILLESFACILITY TYPE:
735
ADDRESS:640 WEST COUNTRY HILLS DRIVETELEPHONE:
(714) 526-4079
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:4CENSUS: 4DATE:
01/18/2024
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Priscilla ObandoTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Administrator is not following required 1/1 care as agreed
Facility does not purchase enough food for the residents in care
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegation(s). LPA met with Staff #1 (S1) Priscilla Obando and explained the reason for today’s inspection. Administrator (AD) Sean Estrella appeared via telephone.

The investigation into the allegations that the administrator is not following required 1/1 care as agreed and the facility does not purchase enough food for the residents in care revealed the following: During the course of the investigation, LPA inspected the facility, interviewed the administrator, staff, and clients, and obtained and reviewed copies of the client roster, staff roster, staff schedules, client weight records, and grocery invoices.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
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 2
Control Number 22-AS-20220623134733
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: EASTERSEALS SOUTHERN CALIFORNIA - COUNTRY HILLS
FACILITY NUMBER: 306005442
VISIT DATE: 01/18/2024
NARRATIVE
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Regarding the allegation that the administrator is not following required 1/1 care as agreed: It was alleged that the facility has been short staffed, especially on the weekends, and that Client #1 (C1) is not receiving one-on-one supervision as required by C1’s care plan and as a result has eloped multiple times. LPA inspected the facility twice and observed that the staffing ratios were being followed. LPA interviewed the administrator who denied the allegation, stating the facility has enough staff to meet all of the clients’ needs as outlined in their care plans at all times, including C1 who needs one-on-one supervision. The administrator confirmed C1 requires one-on-one supervision and that C1 is an elopement risk, but claimed C1 always receives one-on-one supervision and has not eloped recently. LPA interviewed four staff who corroborated the administrator’s statements. LPA conducted interviews with three clients and the information obtained did not corroborate the allegations. LPA reviewed staff schedules for April, May, and June 2022 which show at least two, but more commonly three, staff assigned to each shift which would have allowed at least one staff to provide one-on-one supervision to C1.

Regarding the allegation that the facility does not purchase enough food for the residents in care: It was alleged that the food purchased for the clients is oftentimes spoiled and has to be discarded, the staff do not purchase enough food for the clients in care, and that the facility mostly serves canned foods to the residents. LPA inspected the facility and observed no spoiled or expired foods, proper temperatures in the refrigerator and freezer, purchase/expiration dates written on food items to ensure food items are not kept beyond these dates, the kitchen, refrigerator, and freezer were clean and organized, and the perishable food appeared fresh and included fresh fruit and vegetables. LPA interviewed the administrator and four staff who denied the allegation. LPA conducted interviews with three clients and the information obtained did not corroborate the allegation. LPA reviewed client weight records for four clients and noted that their weights have been stable. LPA reviewed recent grocery invoices which show the facility purchases perishable and non-perishable food weekly. The information obtained did not corroborate the allegation.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the allegations that the administrator is not following required 1/1 care as agreed and the facility does not purchase enough food for the residents in care occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2