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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366424637
Report Date: 07/08/2024
Date Signed: 09/25/2024 12:21:35 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
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/03/2024 and conducted by Evaluator Bernadette Allen
COMPLAINT CONTROL NUMBER: 56-AS-20240703152207
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: 3DATE:
07/08/2024
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Vivian Francisco-AdministratorTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Client engaging in harmful activities due to lack of supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to this facility to initiate the complaint investigation on the mentioned allegation. LPA met with administrator Vivian Francisco who was informed of the purpose of the visit and allegation. The investigation consisted of staff interviews, and review of relevant facility records and video recording.

During interviews with the facility administrator and staff, it was discovered that on June 26, 2024, client #1 (C1) returned from the day program around 2:50 pm, entered the facility and hid from the staff in the laundry room. The video footage shows C1, leaving the facility gate at approximately 2:53 PM, shortly after the transportation van departed. Surveillance cameras show C1 leaving the facility walking next door to the right of the facility attempting to open the car door but was unsuccessful. C1 proceeded down the street to a neighbor’s car, entered the car without permission and took cash money from the car. Surveillance cameras from both the facility and the neighbors captured the incident on June 26, 2024. LPA attempted to interview C1, but they were unwilling to talk.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
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
Control Number 56-AS-20240703152207
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/11/2024
Section Cited
CCR
85065(b)
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85065-Personnel Requirements
(b) The licensee shall employ staff as necessary to ensure provision of care and supervision to meet client needs.
Based on interviews, record review, and video's observed on 6/26/24 the client left the facility after arriving from day program without staff's knowledge,
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The licensee has agreed to provide in-service training to all staff members on the protocol that will be taken upon client’s arrival from day program in the future.
and a statement of understanding of the cited regulation signed and training by all staff.


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the licensee did not ensure supervision for clients,which poses an immedtiate Health, Safety or Personal Rights risk to resident in care.
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Licensee will provide proof of training by the POC date of 7/11/24


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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: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20240703152207
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: 07/08/2024
NARRATIVE
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Based on LPA's observations, interviews, and record reviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated.

An exit interview was conducted where this report was discussed and provided to the Vivian Francisco at the conclusion of the visit with appeal rights.

SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3