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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425801343
Report Date: 08/13/2024
Date Signed: 08/13/2024 05:33:30 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/13/2023 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20230113132249
FACILITY NAME:BAUER RESIDENTIAL-SANTA MARIA IIFACILITY NUMBER:
425801343
ADMINISTRATOR:CLINTON CADLEFACILITY TYPE:
735
ADDRESS:3842 MIRA LOMA DRIVETELEPHONE:
(805) 938-9196
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:4CENSUS: 4DATE:
08/13/2024
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Clinton Cadle, AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Residents sustained multiple bruising while in care.
Facility staff did not meet residents' hygiene needs.
Facility staff did not ensure that a resident received medical treatment.
Facility staff did not ensure that residents received proper nutrition.
Facility staff did not allow residents to freely go to their rooms.
Facility staff did not adequately supervise a resident.
Facility staff did not ensure that residents have clean linens/blankets.
Facility staff did not ensure that a resident was dressed appropriately for the weather/temperature.
Facility staff left a resident soiled for an extended period of time.
Facility staff did not use safety precautions when caring for residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) De Leon conducted a subsequent complaint visit to deliver final findings of the complaint allegations. LPA met with Administrator Clinton Cadle and explained the purpose of the visit.

LPA De Leon conducted the initial 10-day visit, toured the facility, and collected documentation on 01/18/2023. LPA De Leon interviewed staff on 08/01/2024 at 3:39pm, 4:05pm, 4:13pm, 4:18pm, and 4:25pm. LPA Phillips conducted annual visits on 06/27/2023 and 06/22/2024 touring and observing the facility.

On the allegation: Residents sustained multiple bruising while in care. LPA De Leon observed residents on 01/18/2023 on complaint visit and did not see any noticeable bruising on any of the three residents in care.

Continued 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
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 4
Control Number 29-AS-20230113132249
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: BAUER RESIDENTIAL-SANTA MARIA II
FACILITY NUMBER: 425801343
VISIT DATE: 08/13/2024
NARRATIVE
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 All 4 of the residents go to an Adult Day Program and a body check is done daily on their return to the facility from the day program, nothing was noted on any of the four residents in care having any type of bruising. The facility and the day program submit incident reports to the department and no incident reports of any four of the residents was reported with any type of bruising. LPA De Leon interviewed the staff at the facility which revealed none of the four residents had any bruising. LPA De Leon reviewed all the medical records provided by the facility and nothing reported any type of bruising on residents in care. LPA Phillips conducted 2 unannounced annual visits during the investigation, LPA Philips toured the facility, conducted interviews on 06/27/2023 and 06/22/2024 and did not observe any residents with bruising. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff did not meet residents' hygiene needs. LPA De Leon conducted interview with staff which revealed the facility assist the residents with showers two times daily in the morning before they go out in the community for program and before bed. The staff help assist the residents daily with grooming and hygiene. The staff assist and make sure the resident have clean clothing on daily and clean pajamas at night. Staff stated laundry is done daily at the facility with clean clothes, linens, and towels and all items are marked for each resident. Staff stated that all four residents shower twice daily and none of the four residents ever refuse to shower. LPA reviewed incident reports for the facility and the day program and none of the four residents have any reports regarding hygiene. LPA reviewed medical records nothing was noted for any four residents’ hygiene issues or problems. LPA De Leon observed three of the residents in care on 01/18/2023 and did not observe any of the three having any hygiene issues. LPA Phillips conducted unannounced annual visits on 06/27/2023 and 06/22/2024 and did not note any residents with hygiene issues. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff did not ensure that a resident received medical treatment. LPA requested and reviewed medical records on all four residents in care, all four residents had LIC 602 Physicians reports, those that had encounters with ER visits had discharge paperwork on file, Lab orders were on file, CHC summary of visits and Bauer records of Medical and Dental care forms were on file. LPA interviewed staff which revealed the Administrator is in charge of making and taking residents to appointments, Administrator is on top of appointments for residents and they go when they need to, the staff can transport to urgent care and other appointments if needed, and If it is an emergency the staff call 911. The facility residents are Tri-Counties Regional Center (TCRC) clients and are seen on a quarterly and annual basis for Individual Service Plans and assessments. Due to the lack of evidence to support this allegation it is Unsubstantiated.
Continued 9099-C
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20230113132249
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: BAUER RESIDENTIAL-SANTA MARIA II
FACILITY NUMBER: 425801343
VISIT DATE: 08/13/2024
NARRATIVE
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On the allegation: Facility staff did not ensure that residents received proper nutrition. LPA De Leon conducted an unannounced visit to the facility on 01/18/2023 the food supply was checked, and the facility had a plentiful supply of perishable and non-perishable food meeting well beyond the regulation requirements. LPA Phillips conducted two unannounced visits on 06/27/2023 and on 06/22/2024 and on both visits it was noted the food supply was checked and meeting regulation requirements. The residents attend Adult Day Program, and the facility sends residents with a packed lunch. LPA interviewed staff which revealed the facility always has a large supply of notorious groceries, shopping is done bi-weekly, residents are served 3 meals and 2 snacks daily. LPA De Leon checked incident reports for the day program the residents attend, and nothing was noted on any of the four residents having issues with nutritious lunches packed by the facility staff. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff did not allow residents to freely go to their rooms. LPA interviewed staff which revealed the residents are free to roam around the facility throughout the day and night. Residents are free to go to the restroom, living room, kitchen, bedrooms, and outside when they want to. One resident likes to watch the sun rise and the sun set daily and goes outside to do so. All residents attend day program during the weekdays and residents partake in activities they want to. One resident only likes to watch the TV shows the resident likes and the resident likes to go to the bedroom to watch on own personal television when the resident wants to. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff did not adequately supervise a resident. LPA De Leon interviewed staff which revealed they had adequate staffing, supervision, remained in their ratios with TCRC for staffing hours and on any call offs they had backup staff to always provide care and supervision. LPA De Leon reviewed the staff records, LIC. 500 Staff Roster, December 2022-January 2023 Staff schedules, the facility had four residents and was staffing caregivers 3 on the AM shift, 3 on the PM shift and 1 on the NOC shift which meets the hour requirements of TCRC for staffing at the facility. The residents at the facility go to an adult day program and the program staff supervise the residents until they are picked up from program by the facility staff. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.

Continued 9099-C
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 29-AS-20230113132249
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: BAUER RESIDENTIAL-SANTA MARIA II
FACILITY NUMBER: 425801343
VISIT DATE: 08/13/2024
NARRATIVE
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On the allegation: Facility staff did not ensure that residents have clean linens/blankets. LPA interviewed staff which revealed the laundry is done daily for each resident, clothes, towels, and linens. LPA De Leon toured the facility on 01/18/2023, the facility had clean linens and blankets on each resident’s bed. Each resident had a supply of clean extra linens and blankets. LPA Phillips made two unannounced visits on 06/27/2023 and 06/22/2024 and observed resident rooms to have clean linens and blankets as well as extra linens and blankets. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff did not ensure that a resident was dressed appropriately for the weather/temperature. LPA interviewed staff which revealed it is a rule to make sure the residents are dressed appropriately and have a sweater or jacket for cold weather. Staff stated they dress all residents for the weather outside and bring along sweater or jacket in case it gets cold out. LPA De Leon observed on 01/18/2023 the residents at the home were clean and dressed appropriately. LPA Phillips observed the residents clean and dressed appropriately on both annual visits. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff left a resident soiled for an extended period of time. LPA De Leon interviewed staff which revealed the residents took two showers per day morning and evening, none of the residents were incontinent during that time, one resident wore brief pull ups to bed only and resident was checked on through out the night. All residents were able to use the restroom without assistance and if needed staff would aid. LPA De Leon reviewed medical records, and nothing indicated issues with toileting or incontinent, rashes or sores to indicate a resident was being left soiled for a long period of time. The staff do body checks daily after residents return from day program and nothing was noted of a resident being soiled for an extended period or of any rashes, or sores. LPA De Leon observed extra supply of brief pull ups, wipes, toilet paper, and paper towels. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
On the allegation: Facility staff did not use safety precautions when caring for residents. LPA De Leon observed gloves, masks, gowns, hand sanitizer, soap, paper towels, EPA approved disinfectants and cleaners at the facility. Staff interviews revealed staff wear and change gloves with every resident and the transportation van carries a supply of all PPE supplies. Staff are trained annually on infection control and PPE upon hire and annually. LPA Phillips did not find any issues with staff not using safety precautions when providing care to the residents on either of the facilities annual reports. Due to the lack of evidence to support this allegation it is Unsubstantiated at this time.
Exit interview conducted and copy of report printed for Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4