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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366424637
Report Date: 12/06/2023
Date Signed: 12/06/2023 03:30:13 PM

Unsubstantiated


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
11/28/2023 and conducted by Evaluator Anna Bueno
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20231128091324
FACILITY NAME:NEW DISCOVERY RESIDENTIAL SERVICES IFACILITY NUMBER:
366424637
ADMINISTRATOR:VIVIAN FRANCISCOFACILITY TYPE:
735
ADDRESS:26278 DATE STREETTELEPHONE:
(909) 280-9644
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:6CENSUS: 4DATE:
12/06/2023
UNANNOUNCEDTIME BEGAN:
12:47 PM
MET WITH:Vivian FranciscoTIME COMPLETED:
03:32 PM
ALLEGATION(S):
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Staff did not ensure resident was wearing clothing.
Staff locked resident in a room.
Staff did not assist resident with ambulating as needed.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Bueno conducted an unannounced visit to the facility to initiate the complaint investigation and deliver findings on the above allegations. LPA met with administrator Vivian Francisco who was informed of the reason for today's visit. The investigation consisted of staff interviews, and review of relevant records and video recording.

Allegation 1: Staff did not ensure Resident (R1) was wearing clothing. LPA reviewed video evidence from 11/20/23 showing that R1 was fully clothed for at least 39 minutes before appearing without clothing on their bottom half. LPA reviewed records showing documented R1 behavior including removal of clothing resulting in being completely. LPA reviewed R1's behavioral support plan including letting R1 tell staff when R1 is ready to be clothed. This allegation is therefore unsubstantiated.

Allegation 2: Staff locked Resident (R2) in a room. It is alleged that R2 was locked in the office with a bathroom. LPA observed during today's visit and in previous visits that the office is typically locked. During today's visit, LPA observed staff let R2 use the bathroom in the office twice. LPA observed R2 and R3 come and go in the office when the door was left open. Staff interviews revealed that R2 will sometimes take longer to pass urine that other clients who want to use the bathroom will remove R2 from the toilet. Interviews with staff further reveal that the facility has R2 use the office bathroom so they can go undisturbed. This allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
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 2
Control Number 56-AS-20231128091324
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: NEW DISCOVERY RESIDENTIAL SERVICES I
FACILITY NUMBER: 366424637
VISIT DATE: 12/06/2023
NARRATIVE
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Allegation 3: Staff did not assist R2 with ambulating as needed. It is alleged that R2 struggles with ambulation. LPA reviewed 11/20/23 video recording and saw R2 ambulating independently with Staff 1 (S1) assisting by holding R2's back waistband. LPA reviewed records showing that R2 was receiving home health (HH) services since September 2022 which includes, receiving a walking assistive device for their ambulation. LPA further reviewed HH notes between 08/22/23 through 12/5/23 making observations to R2's ambulation. During today's visit, LPA observed R2 ambulating on their own with Staff 2 (S2) walking backwards ahead of R2. This allegation is therefore unsubstantiated.

An allegation of UNSUBSTANTIATED means that 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. No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed with and provided to the Administrator.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2