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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005677
Report Date: 01/27/2025
Date Signed: 01/27/2025 11:30:58 AM

Substantiated


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
01/22/2025 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250122184427
FACILITY NAME:A MISSION FOR MICHAELFACILITY NUMBER:
306005677
ADMINISTRATOR:DAN ROBINSONFACILITY TYPE:
772
ADDRESS:34142 CRYSTAL LANTERNTELEPHONE:
(949) 313-7444
CITY:DANA POINTSTATE: CAZIP CODE:
92629
CAPACITY:6CENSUS: 6DATE:
01/27/2025
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Rey-Philip GenaldoTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Client file records are missing and/or incomplete.
Facility staff are not adequately trained.
Facility does not have a Program Director.
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of investigating the above-mentioned complaint allegations. LPA met with Clinical Director (CD) Rey-Philip Genaldo, discussed the purpose of the inspection, and explained the allegations.

The investigation into the allegations that client file records are missing and/or incomplete, facility staff are not adequately trained, and facility does not have a Program Director revealed the following: During the course of the investigation, LPA inspected the facility, interviewed CD and staff, and obtained and reviewed copies of the client roster, staff roster, the Continued Care Plans for Client #1 (C1), Client #2 (C2), and Client #3 (C3), training records for Staff #1 (S1), and the facility’s 2024 training records.

CONTINUED
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
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 4
Control Number 22-AS-20250122184427
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: A MISSION FOR MICHAEL
FACILITY NUMBER: 306005677
VISIT DATE: 01/27/2025
NARRATIVE
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Regarding the allegation that client file records are missing and/or incomplete: it was alleged that client files do not contain documentation of vocational services provided. LPA reviewed the Continued Care Plans for C1, C2, and C3, which show the clients’ educational and vocational goals, but do not document the steps necessary to reach these goals, the progress of the clients towards reaching these goals, or the services provided by the facility towards reaching these goals. LPA interviewed CD who admitted the allegation and stated that the facility is already updating its processes to document the steps the clients will take to reach their educational and vocational goals and the services provided to the clients at the facility to reach these goals. The information obtained corroborated the allegation.

Regarding the allegation that facility staff are not adequately trained: it was alleged that the staff file for S1 did not contain records showing S1 was trained in the preparation of discharge plans and the staff files for multiple staff did not contain records of 20 hours of continuing education per year. LPA interviewed CD who admitted the allegation and stated S1 has been preparing discharge plans for a long time. LPA reviewed the training records for S1 which corroborated that S1 did not have documented training on preparing discharge plans. LPA reviewed the facility’s 2024 training records which corroborated that four staff did not complete 20 hours of continuing education in 2024. The information obtained corroborated the allegation.

Regarding the allegation that facility does not have a Program Director: it was alleged that the facility does not have an approved program director. LPA interviewed CD who admitted that the prior program director left in 2024 and the facility still does not have an approved program director. The information obtained corroborated the allegation.

During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegations mentioned above. The preponderance of evidence standard has been met; therefore, the above allegations are Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 22-AS-20250122184427
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: A MISSION FOR MICHAEL
FACILITY NUMBER: 306005677
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/24/2025
Section Cited
CCR
81068.2(b)(3)
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81068.2 Needs and Services Plan (b) … a written Needs and Services Plan … must include … (3) A written treatment/rehabilitation plan… This requirement was not met as evidenced by:
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Licensee stated they are updating their processes to include documentation of steps towards goals and services provided towards goals and will submit proof to LPA by POC due date.
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Based on admission and documents, the licensee did not ensure the treatment / rehabilitation plans for 3 clients documented steps towards reaching vocational goals or services provided to help the clients reach their goals, which poses a potential personal rights risk to persons in care.
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Type B
02/24/2025
Section Cited
CCR
81065(r)
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81065 Personnel Requirements … (r) All direct care staff shall receive a minimum of 20-clock-hours of continuing education per year … as appropriate to their job assignment. This requirement was not met as evidenced by:
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Licensee stated they have created a new training plan to meet requirements and will submit training records to LPA by POC due date showing that staff are making progress towards meeting the requirements.
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Based on admission and documents, the licensee did not ensure 4 staff completed 20 hours of continued education in 2024 and that 1 staff had training on preparing discharge plans, which poses a potential safety risk to persons in care.
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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: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 22-AS-20250122184427
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: A MISSION FOR MICHAEL
FACILITY NUMBER: 306005677
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/24/2025
Section Cited
CCR
81064.1(a)
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81064.1 Program Director Qualifications and Duties (a) All social rehabilitation facilities shall have a program director. This requirement was not met as evidenced by:
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Licensee stated they will submit a LIC308, board resolution, resume, and ID for the administrator and the program director to LPA by POC due date.
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Based on admission, the licensee has not had an approved program director since the previous program director left in 2024, which poses a potential safety risk to persons in care.
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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: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4