565801182-8-1-2024-29-AS-KLOZ-D8LVJX-20240829162928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801182
Report Date: 08/01/2024
Date Signed: 08/01/2024 03:17:07 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
07/26/2024 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20240726165711

FACILITY NAME:	ROSE GARDEN MANOR III		FACILITY NUMBER:	565801182
ADMINISTRATOR:	EMMANUEL SORATORIO		FACILITY TYPE:	740
ADDRESS:	831 YALE PLACE		TELEPHONE:	(805) 986-6097
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	6	CENSUS: 5	DATE:	08/01/2024
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Amalia Soratorio		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff are not adequately trained
Staff falsified resident records
Staff are not fingerprint cleared
Residents are being financially abused by the licensee

INVESTIGATION FINDINGS:

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At 11:35 a.m. Licensing Program Analyst (LPA), Esther Cortez along with Tri-Counties Regional Center Quality Assurance Specialist (QAS) Ryan Landseadel conducted an unannounced initial 10-day complaint visit for the above allegations. Upn arrival the LPA and QAS met with administrator Amalia Soratorio. There were no clients present. Administrator Emmanuel Soratorio arrived during the visit and all clients arrived during the visit at 1:30 p.m.

During today's inspection, between 11:35 a.m. and 3:00 p.m., the LPA interviewed the Administrators, two (2) staff, one (1) client, conducted a file review, and obtained copies of records and other pertinent documents relevant to the investigation.

On the allegation that Staff are not adequately trained, it is the reporting party’s concern that staff are working without being trained. Report will continue on LI809-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024

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 29-AS-20240726165711

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ROSE GARDEN MANOR III	FACILITY NUMBER: 565801182
	VISIT DATE: 08/01/2024

NARRATIVE

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To investigate the allegation, the LPA conducted staff record review, and interviewed staff and the administrators. The record review revealed that all staff received the required training and continue to receive on going training. Interview with administrator Emmanuel revealed that the staff receives orientation training, continuation on-site training, CPI training, medication training and Direct Support Professional Training. Staff interviews revealed that they received training in Direct Support Professional training and on-site training. Based on interviews and record review the allegation above is deemed unsubstantiated at this time.

On the allegation that Staff are not fingerprint cleared, it is the concern of the reporting party that staff without background clearance are working at the facility. To investigate the allegation, the LPA requested all staff’s records for the staff reflected on the LIC500 (Personnel Roster). The LPA reviewed records and the reviewed records revealed that all staff members were background cleared and are associated with this facility. Staff interviews confirmed there are no other adults who work at the facility other than those on the staff schedule. Based on interviews and record review the above allegation above is deemed unsubstantiated at this time.

On the allegation that Staff falsified resident records and Residents are being financially abused by the licensee; it is the concern of the reporting party that the Licensee had Staff help in making false documents including receipts for personal purchases being shown as client purchases. To investigate the allegation, the LPA conducted a record review of the clients record of client’s/resident’s safeguard cash resource (LIC 405) for the three clients that the facility safeguards their cash resources for, and conducted interviews. The LPA observed all LIC 405 forms properly documented with each transaction dated, signed by the client, correct amounts and balances, and descriptions documented. The LPA observed supporting receipts that matched the LIC 405 transactions. Administrator Emmanuel conducted an audit of the clients cash in front of the LPA, all amounts and balances matched. Staff interviews revealed that staff buys items the clients ask for during outings and send the receipt to Administrator Amalia. All staff interviewed denied spending clients money or falsifying any records. Client interview revealed that staff helps them buy items they want, and that they are happy at the facility. Based on information gathered, the Department does not have sufficient evidence to determine Staff falsified resident records and Residents are being financially abused by the licensee. Therefore, the above allegation is deemed unsubstantiated at this time.

No citations were issued. Exit interview conducted. A copy of the report was provided to administrator Emmanuel Soratorio.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024

LIC9099 (FAS) - (06/04)

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