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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005938
Report Date: 01/16/2025
Date Signed: 01/16/2025 12:55:38 PM

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
01/02/2025 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250102150232
FACILITY NAME:VIOLA HOMES ESTATEFACILITY NUMBER:
306005938
ADMINISTRATOR:DANIELA TILLESFACILITY TYPE:
735
ADDRESS:810 W. CIRCLE DRIVETELEPHONE:
(714) 867-7070
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:4CENSUS: 4DATE:
01/16/2025
UNANNOUNCEDTIME BEGAN:
07:34 AM
MET WITH:Nicole Turner, Erika PenaTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Facility failed to report bruising to responsible party.
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. LPA met with Staff #1 (S1) Nicole Turner and Staff #2 (S2) Erika Pena and explained the reason for today’s inspection. Administrator (AD) Miatta Snetter appeared via telephone.

The investigation into the allegation that the facility failed to report bruising to responsible party revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, staff, and witnesses, and obtained and reviewed copies of the client roster, staff roster, two facility incident reports dated December 5, 2024, a facility incident report received December 11, 2024, and an incident report dated December 31, 2024 from Client #1’s (C1) day program.

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

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
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 5
Control Number 22-AS-20250102150232
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: VIOLA HOMES ESTATE
FACILITY NUMBER: 306005938
VISIT DATE: 01/16/2025
NARRATIVE
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It was alleged that C1 sustained multiple bruises which were not reported to C1’s responsible party. LPA reviewed two facility incident reports dated December 5, 2024, which state that on December 3, 2024, and December 4, 2024, C1 got into altercations with another client who hit C1, but do not indicate that C1’s responsible party was notified of these incidents. LPA reviewed a facility incident report received December 11, 2024, which indicates that C1 was noted with a bruise on December 9, 2024, but does not indicate that C1’s responsible party was notified of this incident. LPA reviewed the incident reports received in the Orange County Regional Office (OCRO) and confirmed all of these incident reports were properly reported to the OCRO. LPA reviewed an incident report dated December 31, 2024, from C1’s day program which documents an incident on December 27, 2024 at the day program. Per AD, the facility communicates with two responsible parties for C1, but one responsible party wants the facility to communicate with the other responsible party. LPA interviewed this responsible party who confirmed they want the facility to deal with the other responsible party. LPA reviewed text messages between the facility providing notice of the December 9, 2024, and December 27, 2024, incidents to the responsible party designated to receive notifications. However, per the responsible party designated to receive notifications, neither responsible party was aware of the December 3, 2024, and December 4, 2024, incidents and they were surprised learn the details of these incidents. While AD and facility staff stated the facility generally maintains good communication and provides regular notifications to C1’s responsible party, they were unable to provide specific information or any documentation of how and when notice was provided of the December 3, 2024, and December 4, 2024, incidents. The information obtained corroborated the allegation.

During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegation mentioned above. The preponderance of evidence standard has been met; therefore, the above allegation is 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: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20250102150232
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: VIOLA HOMES ESTATE
FACILITY NUMBER: 306005938
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/13/2025
Section Cited
CCR
80061(f)
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80061 Reporting Requirements (f) The items specified in (b)(1)(A) through (H) above shall also be reported to the client's authorized representative, if any. This requirement was not met as evidenced by:
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Licensee stated they will create a new procedure to ensure incidents are properly documented and reported, train staff on the procedure, and submit proof to LPA by POC due date.
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Based on documents and interview, the licensee did not ensure incidents were reported to C1’s responsible party, 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: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5