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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426503
Report Date: 07/07/2023
Date Signed: 07/07/2023 01:21:12 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/10/2023 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20230310080311
FACILITY NAME:PEOPLE'S CARE TRADE WINDSFACILITY NUMBER:
336426503
ADMINISTRATOR:BAZILE, FLORENCEFACILITY TYPE:
735
ADDRESS:25290 TRADE WINDS DRTELEPHONE:
(951) 928-8444
CITY:MENIFEESTATE: CAZIP CODE:
92585
CAPACITY:4CENSUS: 4DATE:
07/07/2023
UNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:ADMINISTRATOR, FLORENCE BAZILETIME COMPLETED:
01:26 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff physically pushed Resident.
Staff sprayed water on face to Resident's face and additional Client.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 07, 2023, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to the facility to deliver the allegation findings and conclude the investigation regarding the listed allegations.

LPA Mixson met with Administrator introduced herself and stated the purpose of the visit. LPA Mixson toured the facility currently in the facility there were four residents and three staff. There were no observable Title 22, Division 6, Regulation violations noted during the tour.

During this visit, LPA Mixson conducted additional staff and resident interviews, record reviews, and made observations pertaining to the listed allegations. LPA Mixson requested and obtained pertinent documents.

On 03/10/2023, Community Care Licensing (CCL), received information regarding the listed allegations. After the LPA's evaluation of staff and resident interviews, record reviews, and observations there was not a preponderance of the evidence strand to demonstrate that the listed allegations did or did not occur. The record reviews showed that R1 has a diagnosis of Prader Willi Syndrome, Intermittent explosive disorder, and Bipolar, Schizoeffective disorder. The records reviewed showed that there is a pattern of behaviors of this type and this is documented. Based on the interviews, record reviews, and observations, there was not sufficient evidence to prove that the listed allegations actually happened. Therefore, the allegation findings have been deemed "UNSUBSTANTIATED." A finding of unsubstantiated means that "although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur," therefore the allegation is unsubstantiated at this time.
An exit interview was conducted and a copy of this report was given to Administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023
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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