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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006315
Report Date: 10/03/2024
Date Signed: 10/03/2024 03:04:05 PM

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
09/23/2024 and conducted by Evaluator Claudia Gutierrez
COMPLAINT CONTROL NUMBER: 22-AS-20240923135752
FACILITY NAME:SERIN HOMESFACILITY NUMBER:
306006315
ADMINISTRATOR:MENDOZA, ALVINFACILITY TYPE:
735
ADDRESS:2051 W. DOGWOOD AVE.TELEPHONE:
(714) 261-4530
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY:4CENSUS: 4DATE:
10/03/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Luis PinedaTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Client was slapped while being bathed by male caregiver.
INVESTIGATION FINDINGS:
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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegation mentioned above. LPA was greeted and granted entry by Staff Luis Pineda. Administrator (AD) Alvin Mendoza was contacted by phone and the purpose of the inspection was discussed.

Interviews were conducted with two of two clients present, staff, and AD. During their interview, Client 1 (C1) stated Staff 1 (S1) had touched their buttocks on one occasion. Per C1, the touch had been with an open hand and illustrated the touch as a pat on their buttock. C1 described the pat as being soft and stated it had not caused pain or bruising. Per C1, they could not recall specific details regarding place, time, or date, and stated they did not have any additional concerns regarding S1. C2 was also interviewed and denied witnessing or having any knowledge of staff slapping any client including C1. C2 stated they had no concerns regarding S1 or any facility staff. (Cont. LIC9099-C)
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
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-20240923135752
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: SERIN HOMES
FACILITY NUMBER: 306006315
VISIT DATE: 10/03/2024
NARRATIVE
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During their interview, S1 denied slapping C1 or any other client. Per S1, while attempting to assist C1 get in the shower they had patted their buttocks with an open hand once. S1 stated this had been an isolated event and stated the pat to C1’s buttocks had been soft and was only meant as a prompt to get into the shower.

During their interview, AD stated they had interviewed S1 and C1 regarding the incident. Per AD, C1 stated S1 had touch their buttocks, but denied it had been a slap and eventually retracted their story. AD stated that S1 had indicated they had touched C1’s buttocks while assisting them in the bathroom, however, stated it was more of a prompt and had not been a deliberate slap.

Due to allegation being uncorroborated during interviews conducted, LPA is unable to determine if client was slapped while being bathed by male caregiver. Although the above 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 at this time the above allegation is unsubstantiated.

An exit interview was conducted and copy of this report was provided at the end of the inspection.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2