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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005466
Report Date: 01/25/2024
Date Signed: 01/25/2024 03:03:00 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
05/03/2022 and conducted by Evaluator Joseph Alejandre
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220503095550
FACILITY NAME:MY DAY COUNTS - TRAINING ACTIVITY PROGRAMFACILITY NUMBER:
306005466
ADMINISTRATOR:BRITTAIN, KINSLEYFACILITY TYPE:
775
ADDRESS:227 W. CARL KARCHER WAYTELEPHONE:
(714) 744-5301
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:200CENSUS: 106DATE:
01/25/2024
UNANNOUNCEDTIME BEGAN:
02:49 PM
MET WITH:Michael GallianoTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility does not adhere to COVID-19 protocol
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation into the allegation listed above. LPA met with Chief Executive Officer Michael Galliano and explained the reason for the visit. The investigation into the allegation, facility does not adhere to Covid-19 Protocol, revealed the following. It was alleged that Client 1 (C1) was not allowed to participate in the Day Program unless they wore a mask. Witness 1 (W1) reported that they were informed by the facility that C1 could not attend the class at the facility unless they wore a mask. On 9/30/2020 the Department (California Department of Social Services) released Provider Information Notice (PIN) 20-33-ASC which states that, “While attending an ADP (Adult Day Program) you are mandated to wear face coverings consistent with the California Department of Public Health’s Guidance for Use of Face Coverings, unless: You have a medical condition, mental health condition, or disability that prevents wearing a face covering.” W1 reported that C1 had a medical condition that would be impacted by wearing a mask.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
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-20220503095550
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: MY DAY COUNTS - TRAINING ACTIVITY PROGRAM
FACILITY NUMBER: 306005466
VISIT DATE: 01/25/2024
NARRATIVE
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Facility staff reported that it was reported to them by C1’s responsible party that C1 had a medical condition but no documentation was provided. W1 reported that C1 continued to participate at the program while wearing a mask. No documentation was provided showing C1 had a medical condition. C1 could not be reached to be interviewed. Facility staff reported that C1 continued to participate and there were no reported issues. Based on the evidence gathered the allegation is deemed unsubstantiated, although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted and a copy of the report provided.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2