365530082-4-4-2025-56-AS-EMAN-DFUUPA-20250418154512

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 365530082
Report Date: 04/04/2025
Date Signed: 04/04/2025 02:01:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 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
04/01/2025 and conducted by Evaluator Beena Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20250401163222

FACILITY NAME:	ALOHA DUMOND HOME		FACILITY NUMBER:	365530082
ADMINISTRATOR:	TALLA, OMAR		FACILITY TYPE:	735
ADDRESS:	7888 DUMOND DR		TELEPHONE:	(626) 675-7256
CITY:	FONTANA	STATE: CA	ZIP CODE:	92336
CAPACITY:	4	CENSUS: 3	DATE:	04/04/2025
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Facility Administrator-Omar Talla		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff forced resident to walk back to facility.
Staff makes resident work at restaurant owned by facility owner.

INVESTIGATION FINDINGS:

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On 4/4/2025 at 8:50 AM, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to initiate and conclude the investigation of and deliver findings to the above mentioned complaints. Lpa Singh was greeted by a staff and gained access to the home. Facility Adminstrator Omar Talla arrived at the facility during the visit, who was informed of the reason for today's visit. The investigation consisted of observations, interviews and records review.

First Allegation: Staff forced resident to walk back to facility.
LPA Investigation comprises of Interviews, records review and Client#1s interview revealed facility staff or restaurant worker helps client with the transport to and from facility. Interview with facility staff and clients does not indicated or showed evidence of staff forced resident to walk back to the facility as client#1 volunteers at the restaurant and facility staff provides transport to the client#1 back to the facility at 6pm when restaurant closes.Staff shift schedule shows the evidence that staff is scheduled to provide full supervision to the clients.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2025

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-20250401163222

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ALOHA DUMOND HOME	FACILITY NUMBER: 365530082
	VISIT DATE: 04/04/2025

NARRATIVE

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Second Allegation: Staff makes resident work at restaurant owned by facility owner.

LPA Singh conducted interviews with clients, during interviews 2 out of 2 clients who were interviewed denied being mistreated, neglected or forced to work by the staff at the facility. LPA Singh conducted interviews with staff and other agency, Staff, client and other agency social worker denied staff makes resident/client work at restaurant owned by facility owner as client works there as a volunteer. Interviews with facility Staff indicated that staff never forces client to work but to keep client occupied during his spare time and client is informed and consented to volunteer at this work place. Records and Interviews with staff and clients, LPA Singh did not find evidence to corroborate that staff forced client to work at the restaurant owned by the facility owner.

Based on the evidence gathered during the investigation, the two allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means 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.

An exit interview was conducted where this report, LIC9099, LIC 9099C were discussed and provided to Facility Staff Len De Guzman.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2025

LIC9099 (FAS) - (06/04)

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