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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006002
Report Date: 03/08/2024
Date Signed: 03/08/2024 09:24:13 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
07/27/2023 and conducted by Evaluator Andrea Mendivil
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230727114637
FACILITY NAME:EASTERSEALS ADULT DAY SERVICESFACILITY NUMBER:
306006002
ADMINISTRATOR:ROXAS, MERVINFACILITY TYPE:
775
ADDRESS:1570 E 17TH STREETTELEPHONE:
(714) 672-0866
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY:50CENSUS: 2DATE:
03/08/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Brandon Turner- Program Coordinator TIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Staff abandoned client
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 Brandon Turner, Program Coordinator and explained the reason for the visit.

The Department received a complaint on 07/27/2023 and LPA Mendivil conduct an initial 10 day visit on 08/02/2023. LPA Mendivil interviewed Former Program Director Evelyn Farooquee and obtained copies of event flyer and access ride records. Regarding the allegation staff abandoned client, the investigation revealed the following:
Client 1 (C1) attended an Angels baseball game on 07/22/2023 where it was alleged staff from Easterseals Adult Day Services abandoned C1 at the stadium. Per interview with Former Program Director Evelyn the Angels baseball game was not an Easterseals event, meaning no staff would be there to watch clients.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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-20230727114637
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: EASTERSEALS ADULT DAY SERVICES
FACILITY NUMBER: 306006002
VISIT DATE: 03/08/2024
NARRATIVE
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Program Director reported that she called C1’s residential home and explained that they would need to provide a ride to and from the game, but the residential home asked Program Director to set up an access ride for C1. Program Director stated that the ride with Access was set up and based on Access records C1 was picked up at his residential facility but was a no show for the pickup after the Angel game. Per interview with witnesses C1 was then brought home by a taxicab, which the facility was responsible for paying for.

Per interview with Program Director Evelyn a companion ticket was offered to C1’s residential facility but was not accepted. LPA Mendivil was unable to interview C1 or other clients that attended the Angel game on 07/22/2023 as they were not available during LPA’s visits on 08/02/2023 and 08/17/2023. LPA’s review of the Angel game flyer it provides the instructions, “ Go to HOME PLATE GATE, tickets will be available at the Easterseals Orange Booth from 4pm-6:30pm, just say your name”. Program Director stated the flyer was supposed to help clients locate their tickets as Easterseals Corporation had a booth at the stadium for a networking event.

Therefore, based on the preponderance of evidence through records reviewed and interviews the allegation that staff abandoned client is determined to be 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 was left at the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2