306006320-7-25-2024-22-AS-MSTC-D9M3ZJ-20240930184138

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006320
Report Date: 07/25/2024
Date Signed: 07/25/2024 05:04:03 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
02/08/2024 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240208121307

FACILITY NAME:	MIRADA MANOR/GREENLEAF		FACILITY NUMBER:	306006320
ADMINISTRATOR:	BROWN, PRECIOUS		FACILITY TYPE:	735
ADDRESS:	8616 GREENLEAF AVENUE		TELEPHONE:	(818) 274-1809
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90620
CAPACITY:	6	CENSUS: 4	DATE:	07/25/2024
		UNANNOUNCED	TIME BEGAN:	04:05 PM
MET WITH:	Joseph Jose		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee did not ensure client's are provided dignity in relationships with staff

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Regarding the allegation: Licensee did not ensure clients are provided dignity in relationships with staff
0 of 6 individuals were able to provide information or evidence to corroborate the allegation above. During interviews it was discovered Staff 1 (S1) is a live-in caregiver and has been observed in pajamas. Staff 3, stated they have seen S1 in pajamas and/or a shower cap. S3 was not sure if any of the clients ever seen S1 in a PJ's or a shower cap. When Staff 2 and Staff 3 were asked if S1 has ever been seen inappropriately dressed around clients, both staff denied ever seeing S1 inappropriately dressed.

Based on the information gathered during the investigation through interviews and document review, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, all allegations are deemed Unsubstantiated.

An exit interview was conducted and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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 1