306005705-6-20-2023-22-AS-AORZ-CTULWP-20230718090724

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005705
Report Date: 06/20/2023
Date Signed: 06/20/2023 09:23:34 AM

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
06/02/2023 and conducted by Evaluator Andrea Mendivil

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230602163217

FACILITY NAME:	EDWARD BOARD AND CARE HOME		FACILITY NUMBER:	306005705
ADMINISTRATOR:	HERNANDEZ, MARISA		FACILITY TYPE:	735
ADDRESS:	117 EDWARD AVE.		TELEPHONE:	(714) 290-3809
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92833
CAPACITY:	4	CENSUS: 3	DATE:	06/20/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Esperanza Ramirez- Caregiver		TIME COMPLETED:	09:40 AM

ALLEGATION(S):

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Facility did not safeguard client's cash resources

INVESTIGATION FINDINGS:

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On this day Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility by Caregiver Esperanza Ramirez and explained the reason for the visit. Administrator Marisa Hernandez was available via telephone.

The department received a complaint on 06/02/2023 and the initial 10 day visit was conducted on 06/08/2023. During the initial visit LPA Mendivil reviewed pertinent documents such as Individual Program Plan, quarterly report and staff files. Regarding the allegation, Facility did not safeguard client's cash resources, the investigation revealed the following:

It was reported that funds had been taken out of Client 1's (C1) bank account and it was alleged Staff 1 (S1) had stolen checks from C1 and used them to obtain funds. It was reported by multiple witnesses C1 discovered that their bank account had insufficient funds after making a purchase. C1 reported the issue to their family.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20230602163217

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: EDWARD BOARD AND CARE HOME	FACILITY NUMBER: 306005705
	VISIT DATE: 06/20/2023

NARRATIVE

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Based on statements from witnesses a police report was filed. It was reported by Administrator Marisa Hernandez, S1 abruptly quit, once the missing money issue was discovered. Per review of the departments internal system S1 had passed background clearance and was trained on mandated reporting and personal rights.

Per review of C1's IPP dated 07/02/2022 C1 is able to manage their own finances with the assistant of family, it also states C1 is able to maintain employment. Although there was an alleged theft the facility, the facility acted responsibly by ensuring S1 was properly background cleared and trained. Therefore based on the preponderance of evidence the allegation that facility did not safeguard client's cash resources is UNSUBSTANTIATED, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred. This agency has investigated this complaint.

No deficiencies cited.

An exit interview was conducted and a copy of this report and confidential names list was provided

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2023

LIC9099 (FAS) - (06/04)

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