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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361800141
Report Date: 06/05/2024
Date Signed: 06/05/2024 03:09:31 PM

Substantiated


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
05/29/2024 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240529103757
FACILITY NAME:FIRST STEP INDEPENDENT LIVING INCFACILITY NUMBER:
361800141
ADMINISTRATOR:SLAUGHTER, LANAIRFACILITY TYPE:
775
ADDRESS:3654 HIGHLAND AVE STE 17TELEPHONE:
(909) 483-2505
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:75CENSUS: 55DATE:
06/05/2024
UNANNOUNCEDTIME BEGAN:
12:55 AM
MET WITH:Marcia Ramos, Program Director TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not ensure client's toileting needs were met in a timely manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with Program Director Marica Ramos and explained the elements of the complaint. The investigation was based on staff interviews, consumer interviews and documentation.

Regarding the allegation that staff did not ensure client's toileting needs were met in a timely manner; LPA Prieto interviewed Program Director Ramos, who states they are aware of the staff and consumer (C1) involved in this complaint and measures were taken by Ramos to discipline staff (S1) an provide training to S1 to assure staff are aware of a more effective communication with consumers and aware of their personal rights. C1 was interviewed, who stated that the incident did occur. ***continued on LIC 9099C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
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 5
Control Number 56-AS-20240529103757
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: FIRST STEP INDEPENDENT LIVING INC
FACILITY NUMBER: 361800141
VISIT DATE: 06/05/2024
NARRATIVE
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Documentation was obtained from Director Ramos regarding the training provided to the staff in question (S1) and training documentation.

Based on LPA observations, interviews which were conducted and records review, the preponderance of evidence standard has been met. Therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division) are being cited on the attached LIC 9099D).
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 56-AS-20240529103757
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: FIRST STEP INDEPENDENT LIVING INC
FACILITY NUMBER: 361800141
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/05/2024
Section Cited
CCR
82072(a)(1)
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82072 PERSONAL RIGHTS
(a) Each client shall have personal rights which include, but are not limited to, the following:
(1) To be accorded dignity in his/her personal relationships with staff and other persons. This was not met as evidenced by:
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Director is to provide LPA with staff training in "Effective Communication, Individual Rights and Individual Supervision, in writing, to LPA by POC date
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Staff did not ensure that consumer was provided toileting needs in a timely manner.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
05/29/2024 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240529103757

FACILITY NAME:FIRST STEP INDEPENDENT LIVING INCFACILITY NUMBER:
361800141
ADMINISTRATOR:SLAUGHTER, LANAIRFACILITY TYPE:
775
ADDRESS:3654 HIGHLAND AVE STE 17TELEPHONE:
(909) 483-2505
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:75CENSUS: 55DATE:
06/05/2024
UNANNOUNCEDTIME BEGAN:
12:55 AM
MET WITH:Marcia Ramos, Program Director TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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3
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5
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9
Staff force-fed client in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with Program Director Marica Ramos and explained the elements of the complaint. The investigation was based on staff interviews, consumer interviews and documentation.

Regarding the allegation that staff force-fed client in care; LPA Prieto interviewed consumer in question (C1) who states that she was not force fed by staff, but that the food that was given to C1 was hot. C1 stated that upon letting the staff know that the food was hot, S1 discontinued to feed C1 with no further incident. LPA interview with Director Ramos, revealed that there was no mention of C1 being forced fed by other staff or C1.
***continued in LIC 9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20240529103757
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: FIRST STEP INDEPENDENT LIVING INC
FACILITY NUMBER: 361800141
VISIT DATE: 06/05/2024
NARRATIVE
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Based on the information obtained there is not enough evidence that staff force-fed client in care . Therefore, the allegations that is deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Director Ramos and a copy of this report was left at the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5