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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604148
Report Date: 08/07/2023
Date Signed: 08/07/2023 03:30:16 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, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/20/2022 and conducted by Evaluator Rebecca A Ruiz
COMPLAINT CONTROL NUMBER: 08-AS-20220120093632
FACILITY NAME:ABIGAIL'S HOMES IIFACILITY NUMBER:
374604148
ADMINISTRATOR:GONZALEZ, BRENDA ABIGAILFACILITY TYPE:
735
ADDRESS:8738 VALENCIA STTELEPHONE:
(619) 315-7407
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:4CENSUS: 1DATE:
08/07/2023
UNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:DSP Dario GonzalesTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not treat client with dignity
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced complaint visit to deliver findings regarding the above-mentioned allegation. LPA identified herself to, was greeted by, and explained the purpose of the visit to DSP Dario Gonzales. LPA spoke to Administrator Brenda Gonzalez via phone.

The Department’s investigation consisted of interviews with staff and outside sources, records review, and a tour of the facility. It was alleged that staff did not treat client with dignity. Review of Client 1’s (C1) assessment documents revealed that C1 had a history of emotional outbursts, false statements, and disruptive behaviors, preferred to use their personal cell phone instead of participating in activities, and needed an average of 3 verbal prompts to engage in activities. C1 would often engage in those behaviors when C1 became upset. Interviews revealed that C1 would often become upset with staff when C1 was asked to stop using their personal cell phone due to care or safety reasons. It was alleged that in January 2022, C1 reported that Staff 1 (S1) verbally threatened and cursed at C1.
Continued on LIC9099-C page...
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
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 3
Control Number 08-AS-20220120093632
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ABIGAIL'S HOMES II
FACILITY NUMBER: 374604148
VISIT DATE: 08/07/2023
NARRATIVE
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Interviews with S1 revealed that C1 had said something to S1 that S1 believed was disrespectful. In response to C1’s statement, S1 had told clients, including C1, that S1 was no longer going to take them on the planned outing, which resulted in C1 becoming upset and yelling and cursing at S1 while S1 was driving. Interviews revealed that S1 had to stop driving the vehicle at least once while C1 yelled and cursed at S1. Interviews revealed that S1 stated that S1 had probably yelled at C1 during the interaction. Interviews revealed that S1 had made statements to clients in the past that had upset them and S1 admitted that they should not have made those statements to clients. Interviews with outside sources revealed that while C1 had a history of false statements, C1 would change their description of the event and apologize for making false statements. Interviews revealed that C1’s description of the altercation had not changed. The Department was unable to interview C1.

The Department has investigated the above-mentioned allegation and based on interviews and records review, the preponderance of the evidence has been met, therefore, this allegation is deemed substantiated. The following deficiency is cited per CA Code of Regulations Title 22 and noted on the attached LIC9099-D page.

An exit interview was conducted with DSP Dario Gonzales and Administrator Brenda Gonzalez via phone, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 01/16).
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20220120093632
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ABIGAIL'S HOMES II
FACILITY NUMBER: 374604148
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/21/2023
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights (a)… each client shall have personal rights which include… (1) to be accorded with dignity in his/her personal relationships with staff and other persons. This requirement has not been met as evidenced by:
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Administrator stated that she will assign personal rights training for staff to complete via Relias. Administrator will submit staff completion certificates to the Department by POC due date.
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Based on interviews and records review, the Licensee did not ensure that C1 was accorded with dignity with their relationships with staff. This poses a potential personal rights risk to 1 of 1 clients 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: Lizzette Tellez
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3