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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 361800141
Report Date: 05/26/2023
Date Signed: 05/26/2023 10:01:00 AM

Document Has Been Signed on 05/26/2023 10:01 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 INCFACILITY NUMBER:
361800141
ADMINISTRATOR:SLAUGHTER, LANAIRFACILITY TYPE:
775
ADDRESS:3654 HIGHLAND AVE STE 17TELEPHONE:
(909) 483-2505
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY: 75CENSUS: DATE:
05/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Marcia Ramos - AdministratorTIME COMPLETED:
10:01 AM
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced case management visit to this facility in regards to an incident report received by CCL Regional Office.. LPA met with day program manager Marcia Ramos who were informed of the reason for visit.

On 5/15/2023, LPA received a voicemail from Supervisor indicating that a client was called names by staff at the day program. On 5/17/2023, the Regional Office received an incident report and SOC341 dated 5/12/2023 stating that Staff 1 (S1) called Client 1 (C1) an "expletive animal" multiple times. The incident was witnessed by Staff 2 (S2) who reported the incident to their Supervisor. The program reported the incident per regulation.

During today's visit, it was discovered that S1 had been placed on an unpaid administrative leave effective 5/15/2023 to date. LPA reviewed staff files C1 continues to attend the day program and S2 is still on schedule. LPA interviewed Manager who acknowledged that a company internal investigation and an investigation by Inland Regional Center is open. Manager stated that should S1 return, S1 will undergo re-training and may not work with C1 directly.

LPA and Manager toured the facility and no deficiencies were observed during today's visit. A copy of this report was reviewed with and provided to Manager at the conclusion of this visit.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE: DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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