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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366423467
Report Date: 08/24/2021
Date Signed: 08/24/2021 03:48:49 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
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/20/2020 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200520092025
FACILITY NAME:NEW DISCOVERY RESIDENTIAL SERVICES #5FACILITY NUMBER:
366423467
ADMINISTRATOR:BRYAN CLARDYFACILITY TYPE:
735
ADDRESS:33974 AVENUE "H"TELEPHONE:
(909) 570-9802
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY:4CENSUS: 3DATE:
08/24/2021
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Donna Weldon - AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff yelled at resident's.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility to follow up on the open complaint with the allegation(s) above. LPA Colvin met with Administrator Donna Weldon and advised her of the purpose of today's visit. Below is a summary of the findings of the investigation:

Regarding allegation "Staff yelled at resident's": Interviews conducted by LPA Colvin and LPA Elton Harps revealed that on numerous occasions the previous Administrator (S1) and another prior staff member (S2) would yell at resident(s) in the facility. Interviews state that the residents would be threatened with having their money withheld or other material items withheld, as well as yelled at to go to their rooms and stay in there all day. Therefore, based on interviews conducted, the allegation "Staff yelled at resident's" is SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation(s) is valid because the preponderance of the evidence standard has been met.
Due to observations made by LPA Colvin, the facility was cited. An exit interview was conducted with Administrator Donna Weldon and a copy of this report, LIC9099D, and appeal rights was provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
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 3
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
05/20/2020 and conducted by Evaluator Crystal Colvin
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200520092025

FACILITY NAME:NEW DISCOVERY RESIDENTIAL SERVICES #5FACILITY NUMBER:
366423467
ADMINISTRATOR:BRYAN CLARDYFACILITY TYPE:
735
ADDRESS:33974 AVENUE "H"TELEPHONE:
(909) 570-9802
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY:4CENSUS: 3DATE:
08/24/2021
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Donna Weldon - AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff restrained resident's.
INVESTIGATION FINDINGS:
1
2
3
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5
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7
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9
10
11
12
13
Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility to follow up on the open complaint with the allegation(s) above. LPA Colvin met with Administrator Donna Weldon and advised her of the purpose of today's visit. Below is a summary of the findings of the investigation:

Regarding allegation "Staff restrained resident's": Multiple interviews were conducted over the course of this investigation. Interviews conducted by LPA Colvin were inconclusive, as there were contradicting information from several persons interviewed. LPA Colvin was unable to confirm the allegation due to lack of evidence available to conclusively show that staff restrained residents in a manner that is not approved. Therefore, due to interviews conducted, the allegation "Staff restrained resident's" is UNSUBSTATIATED. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted with Administrator Donna Weldon and a copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20200520092025
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
RIVERSIDE, CA 92507

FACILITY NAME: NEW DISCOVERY RESIDENTIAL SERVICES #5
FACILITY NUMBER: 366423467
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/27/2021
Section Cited
CCR
80072(a)(3)
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Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include...the following: (3) To be free from...intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature... This requirement was not met as evidenced by:
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Licensee agrees to have all staff re-trained on personal rights of residents. Proof of training to be submitted to LPA Colvin by the Plan of Correction date of 8/27/21.
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Based on interviews, the Licensee failed to comply with the above regulation with at least two residents. LPA Colvin learned through interviews that S1 & S2 would yell at resident(s) and threaten/intimidate them into complying with wanted behavior. This was an immediate personal rights violation of residents in care.
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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: Joel Esquivel
LICENSING EVALUATOR NAME: Crystal Colvin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3