366424638-5-22-2023-56-AS-NBRN-CSYT4L-20230620142405

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366424638
Report Date: 05/22/2023
Date Signed: 05/22/2023 04:10:47 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
05/18/2023 and conducted by Evaluator Anna Bueno

COMPLAINT CONTROL NUMBER: 56-AS-20230518124918

FACILITY NAME:	NEW DISCOVERY RESIDENTIAL SERVICES II		FACILITY NUMBER:	366424638
ADMINISTRATOR:	DONNA WELDON		FACILITY TYPE:	735
ADDRESS:	3750 OLEANDER DR.		TELEPHONE:	(909) 280-9637
CITY:	HIGHLAND	STATE: CA	ZIP CODE:	92346
CAPACITY:	6	CENSUS: 3	DATE:	05/22/2023
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Bryan Clardy - Administrator		TIME COMPLETED:	04:11 PM

ALLEGATION(S):

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Uncleared staff working in facility.
Staff stole residents' medications.

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 administrators Bryan Clardy and Vivian Francisco. LPA informed Clardy and Francisco of the reason for visit. The investigation consisted of clients and staff interviews, and review of relevant records.

Allegation 1: Uncleared staff working in facility. LPA reviewed records and found S1 is cleared and associated to the facility. Staff interviews reveal that S2 is in charge of maintenance and supply delivery but reports at the corporate office. Human resources (HR) manager confirmed that S2 is not associated to any facilities as they do not provide care or supervision to any clients. Staff interviews confirm that S2 only drops of supplies for the home and only provides regular maintenance when all clients are on an outing. This allegation is therefore unsubstantiated.

Allegation 2: Staff (S3) stole residents' medications. Interview with S3 revealed that they are not typically

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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-20230518124918

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 II	FACILITY NUMBER: 366424638
	VISIT DATE: 05/22/2023

NARRATIVE

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scheduled to work at this facility and S3 denied stealing any medication. LPA reviewed medication administration records and medications and did not find missing medication. LPA observed that scheduled medications have no refills and the facility will have to contact the pharmacy for refills. Interview with staff revealed that the facility has cameras throughout the facility and have not observed S3 taking any of the client's medications. This allegation is unsubstantiated.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated at this time. No deficiencies were cited during this visit. An exit interview was conducted where this report was discussed and provided to the Administrator.

SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Anna Bueno
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC9099 (FAS) - (06/04)

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