306006395-6-19-2024-22-AS-SSAS-D6F2HP-20240620172505

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006395
Report Date: 06/19/2024
Date Signed: 06/19/2024 10:53:32 AM

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
06/03/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240603112711

FACILITY NAME:	BAKER HOME		FACILITY NUMBER:	306006395
ADMINISTRATOR:	SAN DIEGO, CATHERINE		FACILITY TYPE:	735
ADDRESS:	624 W BAKER AVENUE		TELEPHONE:	(714) 270-9866
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92832
CAPACITY:	4	CENSUS: 4	DATE:	06/19/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Michael Sandiego, Administrator		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff inappropriately exposed herself to resident

Staff did not ensure resident had privacy

Staff made inappropriate comments towards resident

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 delivering findings into the investigation of the three allegations listed above. LPA was greeted and granted entry by facility caregiving staff after stating the reason for the visit. Administrator Michael San Diego was notified of the visit by telephone and arrived later to assist.

An initial complaint investigation was conducted on June 7. 2024. During the visit, LPA reviewed records maintained at the facility for the four currently admitted clients. LPA accompanied by facility staff made a tour of the physical plant. Two staff interviews were conducted. Two clients were out at day program during the visit, one client was reported to be out in the community. The fourth client was present and agreed to an interview with LPA.

CONTINUED ON FORM LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

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-20240603112711

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BAKER HOME	FACILITY NUMBER: 306006395
	VISIT DATE: 06/19/2024

NARRATIVE

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CONTINUED FROM FORM LIC9099
An additional witness interview was conducted via telephone with Regional Center of Orange County staff on June 18, 2024.

Regarding the allegation that Staff inappropriately exposed herself to a client, the following has been concluded: Staff member S1 gave the account that she shared a personal experience regarding her diagnosis of Stage 1 breast cancer with facility client C1 as a motivational speech attempt as the client was reporting feeling depressed. S1 denies any inappropriate exposure. A call to local law enforcement was made later the same day and did not result in a report being filed or any formal investigation. No other direct witnesses were present at the time, but staff, client and witness interviews conducted during the investigation concurred that the allegation was highly unlikely.

Regarding the allegation that Staff did not ensure resident had privacy, the following has been concluded: upon admission, C1 initially declined the offer of having a lock placed on her door for their own use and privacy before changing their mind and requesting a lock to be installed a few weeks later. During the tour of the physical plant, it was confirmed that the lock was in place, with C1 in possession of one of the keys, and a copy of the key maintained in the facility's office for safety reasons. Interviews conducted with facility clients and staff members confirm that adequate measures appear to be taken to ensure the clients' privacy.

Regarding the allegation that Staff made inappropriate comments towards resident, the following has been concluded: other staff members interviewed during the initial investigation all stated that no inappropriate comments or behavior had been witnessed during their time at the facility. A witness interview with Regional Center of Orange County Service Coordinator staff also evidenced the presence of a pattern of similar allegations being made by C1 at their previous placement facility in order to "sabotage [their] placement". Client interview conducted during the initial investigation also failed to corroborate any occurrence of inappropriate comments from staff being witnessed.

As a result of the investigation, the three allegations listed above are found to be Unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred. An exit interview was conducted and a copy of this report was provided to a facility representative.

SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC9099 (FAS) - (06/04)

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