331880820-5-31-2024-56-AS-EMAN-D6KTMS-20240625145133

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880820
Report Date: 05/31/2024
Date Signed: 05/31/2024 11:50:49 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/07/2024 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240507083144

FACILITY NAME:	YEMMA CARE HOME INCORPORATION		FACILITY NUMBER:	331880820
ADMINISTRATOR:	OYEBOBOLA, OLAYEMI		FACILITY TYPE:	735
ADDRESS:	24507 POINSETTIA DRIVE		TELEPHONE:	(818) 213-8485
CITY:	LAKE ELSINORE	STATE: CA	ZIP CODE:	92532
CAPACITY:	4	CENSUS: 4	DATE:	05/31/2024
		ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Licensee/Administrator Emmanuel Oyebobola		TIME COMPLETED:	11:55 PM

ALLEGATION(S):

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Staff did not provide adequate food service.
Staff did not provide a safe and comfortable environment for residents.

INVESTIGATION FINDINGS:

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On 05/31/2024 at 11:00 AM, Licensing Program Analyst (LPA) Melody Brown met with Licensee/Administrator Emmanuel Oyebobola at Community Care Licensing Division (CCLD) Adult and Senior Care (ASC) Regional Office to deliver the findings of the above allegations. LPA Brown explained the purpose of the requested Office Visit. The investigation consisted of observation, interviews, and a review of pertinent documentation.

The investigation was conducted by LPA Melody Brown. The investigation consisted of observation and interviews with relevant parties. The allegation indicates that Staff did not provide adequate food service. During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with Client #2 (C2) and Client #3 (C3) indicated that staffs at the facility are providing adequate food service. Client #1 (C1) reported to LPA Brown that C1's on elective meal service and receiving $100/week food allowance to purchase own food. LPA Brown interviewed Client #4 (C4) and C4 indicated receiving $70/week food allowance at the facility as C4's on elective meal service as well. ***Continuation on LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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 56-AS-20240507083144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: YEMMA CARE HOME INCORPORATION	FACILITY NUMBER: 331880820
	VISIT DATE: 05/31/2024

NARRATIVE

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Interviews with four (4) of four (4) staffs indicated that all staff are providing adequate food service to their clients at the facility. Staff interviews revealed that they always do their grocery shopping twice a week and there's no incident that they did not provide adequate food service to their clients. During the facility visit on 05/08/2024 and 05/28/2024, LPA Brown observed two days supply of perishable food and seven (7) days supply of non-perishable food and LPA Brown observed personal refrigerator in Client #1 (C1) and Client #4 (C4) bedrooms. In addition, LPA Brown observed Staff #3 (S3) cooking food for their clients at the facility on 05/08/2024 and Staff #2 (S2) preparing and cooking food for dinner on 05/28/2024. Licensee/Administrator Emmanuel Oyebobola reported to LPA Brown that Client #1 (C1) and Client #4 (C4) can get any food at the facility if they prefer. LPA Brown reviewed facility grocery receipts and it showed that regular visits to the grocery twice a week. LPA Brown contacted C1 Inland Regional Center (IRC) Consumer Services Coordinator, and IRC CSC reported that C1 has tendency to manipulate and has history of false statement but not documented as C1 family member reported that C1 twist words around as evidenced of telling one thing to C1's family and tell another thing to the facility.

The second allegation indicates Staff did not provide a safe and comfortable environment for residents. Interviews with three (3) of four (4) clients indicated that staffs at the facility are providing safe and comfortable home, that they feel safe and comfortable at the facility. Interviews with four (4) of four (4) staffs indicated that they are providing safe and comfortable environment for their clients at the facility. LPA Brown contacted C1 Inland Regional Center (IRC) Consumer Services Coordinator, and IRC CSC reported that C1 has tendency to manipulate and has history of false statement but not documented as C1 family member reported that C1 twist words around as evidenced of telling one thing to C1's family and tell another thing to the facility. During the facility visit on 05/08/2024 and 05/28/2024, LPA Brown observed the facility located in a gated community, their front door was locked and the facility was observed clean, equipped with required furniture, appliances in good working condition, a Log In/Log Out Sheet observed and LPA Brown observed that they are providing comfortable temperature for their clients in care.

Based on interviews and records review, the allegation Staff did not provide adequate food service (Allegation #1) and Staff did not provide a safe and comfortable environment for residents (Allegation #2) are UNSUBSTANTIATED. A finding of unsubstantiated means 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.

An exit interview was conducted, where this report (LIC9099) was discussed and provided to Licensee/Administrator Emmanuel Oyebobola.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC9099 (FAS) - (06/04)

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