<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366423467
Report Date: 08/24/2021
Date Signed: 08/24/2021 03:50:45 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
COMPLAINT CONTROL NUMBER: 18-AS-20200520100320
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 yells at clients while in care

Facility has inadequate record keeping
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
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 yells at clients while in care": Interviews conducted through the course of this investigation revealed that prior staff members (S1 & S2) yelled at resident(s) on mulitple occasions. Statements collected state that S1 & S2 would yell at resident(s) in order to have them "behave" or exhibit a behavior that they approved of, such as sleeping in their room all day. Therefore, based on interviews conducted, the allegation "staff yells at clients while in care" is SUBSTANTIATED.

Regarding the allegation "Facility has inadequate record keeping": Multiple staff were interviewed during the course of this investigation, and all persons interviewed by LPA Colvin regarding this allegation confirmed that they were previously instructed to delete or alter notes for residents by the prior Administrator (S1).
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 4
Control Number 18-AS-20200520100320
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
VISIT DATE: 08/24/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Interviews stated that such instructions would be in relation to changing the documentation on how an incident occurred, and if allegations were made by a resident against a staff member. Some persons interviewed additionally stated that if they refused to change their note to reflect something that was not true, that someone else would go in and change it. By altering or deleting notes on residents to erase details or change how the event is documented, the facility failed to keep accurate records on residents. Therefore, based on interviews conducted, the allegation "Facility has inadequate record keeping" 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.
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
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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-20200520100320

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 inappropriately restraining clients while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
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 inappropriately restraining clients while in care": Multiple interviews were conducted during the course of this investigation. LPA Colvin was unable to confirm this allegation's validity due to conflicting statements made by parties interviewed. It is common in these adult facilities to use a method of restraint called CPI, which is approved by the residents' placement agency and staff are trained on annually. LPA Colvin was unable to determine if staff used a restraint method other than CPI on residents in care. Therefore, based on interviews, the allegation "Staff inappropriately restraining clients while in care" is UNSUBSTANTIATED. 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 4
Control Number 18-AS-20200520100320
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
80065(l)
1
2
3
4
5
6
7
Personnel Requirements: (l) Personnel shall provide for the care and safety of persons without physical or verbal abuse, exploitation or prejudice. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee agrees to develop a plan to audit staff's interactions with residents periodically to ensure that more oversight is provided to protect residents' rights. Licensee to provide LPA Colvin with developed plan to be added to the facility's Program Plan by the Plan of Correction date of 8/27/21.
8
9
10
11
12
13
14
Based on interviews, the Licensee did not comply with the above regulation with at least two staff (S1 & S2). Interviews conducted revealed that S1 & S2 yelled at resident(s) on multiple occasions. This was an immediate personal rights violation of residents in care.
8
9
10
11
12
13
14
Type B
08/31/2021
Section Cited
CCR
80070(a)
1
2
3
4
5
6
7
Client Records: (a) The licensee shall ensure that a separate, complete, and current record is maintained in the facility for each client. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee agrees to develop plan to help protect the authenticity of staff's notes from being changed or deleted by others or by the instruction of others. Licensee to provide LPA Colvin with plan which shall be incorporated into the facility's Program Plan by Plan of Correction date of 8/31/21.
8
9
10
11
12
13
14
Based on interviews conducted, the Licensee did not comply with the above regulation. Interviews conducted confirmed that staff were instructed by the prior Administrator (S1) to alter their notes to conceal/change information. This presented a potential health and safety risk for all residents in care.
8
9
10
11
12
13
14
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: 4 of 4