306006192-4-10-2023-22-AS-SSAS-CQUQ6Y-20230413115420

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006192
Report Date: 04/10/2023
Date Signed: 04/10/2023 02:31:23 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 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
04/04/2023 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230404150917

FACILITY NAME:	VIOLA HOMES ESTATE		FACILITY NUMBER:	306006192
ADMINISTRATOR:	SNETTER, MIATTA		FACILITY TYPE:	735
ADDRESS:	15770 AZALEA WAY		TELEPHONE:	(323) 304-4620
CITY:	WESTMINSTER	STATE: CA	ZIP CODE:	92683
CAPACITY:	4	CENSUS: 4	DATE:	04/10/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Gazel Montes, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility is mismanaging clients' medications.

Insufficient staffing to meet client needs.

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting an initial investigation into the two allegations listed above. LPA was greeted and granted entry by caregiving staff present at the facility after introducing himself and stating the allegations being investigated. Administrator Gazel Montes was later notified of the visit via telephone and spoke with LPA. Administrator later arrived to assist with the visit and review the findings delivered.

LPA accompanied by caregiver conducted a tour of the facility. There are currently four clients in care, however no clients are initially present as three of them are attending day program and the fourth one is away on family visit. Caregiving staff present is observed to be performing housekeeping tasks in the absence of the clients.

CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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-20230404150917

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: VIOLA HOMES ESTATE	FACILITY NUMBER: 306006192
	VISIT DATE: 04/10/2023

NARRATIVE

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CONTINUED FROM FORM LIC9099

LPA then requested, obtained and reviewed the staff records kept at the facility, along with the Medication Administration Records and documentation of staffing hours provided by the facility administrator.

Regarding the allegation that Facility is mismanaging clients' medications, the following has been concluded: All currently employed and scheduled staff members have received and documented the required training for medication administration. Medication Administration Records were requested, obtained and reviewed for all four clients. Records document all doses appropriately and are updated to reflect the latest prescription information applicable for each client. Destruction records are also observed to be accurate and complete. Therefore the allegation that Facility is mismanaging clients' medications is deemed to be Unsubstantiated, meaning that 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.

Regarding the allegation that there is Insufficient staffing to meet client needs, the following have been concluded: Based on a review of files provided and interviews conducted, it was confirmed that there are systematically two to three direct care staff present whenever clients are present at the facility, as well as awake overnight staff. Therefore the allegation that there is Insufficient staffing to meet client needs is deemed to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Additionally, LPA provided a consultation regarding staff association as all staff members besides the licensee are showing active associations to the facility's other location in La Habra, bearing the license #306005938. A Technical Assistance Advisory Note to that extent was issued during the visit.

An exit interview was conducted and a copy of this report was reviewed and provided to facility representative.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

LIC9099 (FAS) - (06/04)

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