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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005931
Report Date: 07/10/2024
Date Signed: 07/10/2024 04:33:22 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
07/08/2024 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240708143324
FACILITY NAME:VA & C HOMES / TERANIMARFACILITY NUMBER:
306005931
ADMINISTRATOR:AU, ANTHONYFACILITY TYPE:
735
ADDRESS:3034 W. TERANIMAR DRTELEPHONE:
(714) 723-6845
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:6CENSUS: 6DATE:
07/10/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Augustine Au- AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit a client.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the 10-day complaint investigation into the above allegation. LPA was allowed entry after explaining the purpose of the visit to Care Staff Lan Nguyen. Adminstrator Augustine Au arrived at the facility approximately 1:53pm. During the course of the investigation, LPA interviewed three staff and two clients. Three out of the six client interviews that were attempted could not be qualified due to their medical conditions and one client on vacation. Copies of pertinent client/staff records were requested to be sent via email by July 11, 2024. The investigation revealed the following: It is alleged that the staff hit a client. It was determined based on the interviews with two out of the two clients and three out of the three staff did not corroborate with the allegation. Therefore, based on the interviews which were conducted and the records that were reviewed, 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, therefore the above allegation is deemed UNSUBSTANTIATED. An exit interview was conducted with Adminstrator Augustine Au, and a copy of this report was provided at the end of the visit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jessica Cho
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
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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