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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565802463
Report Date: 06/21/2022
Date Signed: 06/21/2022 04:02:40 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,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2022 and conducted by Evaluator Kelly Dulek
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20220613090428
FACILITY NAME:PEOPLE'S CARE HOWEFACILITY NUMBER:
565802463
ADMINISTRATOR:CARLOS MARCIAFACILITY TYPE:
735
ADDRESS:3851 HOWE RDTELEPHONE:
(805) 398-5096
CITY:FILLMORESTATE: CAZIP CODE:
93015
CAPACITY:0CENSUS: 5DATE:
06/21/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Carlos MarciaTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff speaks inappropriately to client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kelly Dulek, along with Tri-Counties Regional Center Quality Assurance Specialist (QA) Liz Aced-Arnett conducted an unannounced initial complaint visit to the above facility. LPA and QA initally met with staff Jazmine Viorato. Administrator Carlos Marcia arrived at 11:17AM. Entrance interview conducted and the reason for the visit was explained.

During today's visit, LPA and QA interviewed Administrator at 11:17AM, facility tour at 11:53AM, staff interviews at 12:10PM and 2:16PM, and client interviews at 1:54PM and 2:00PM. LPA reviewed pertinent documents. The following was then determined:

During an interview with Client #1 (C1,) C1 indicated "staff are mean" but when asked what the staff do that are mean, C1 stated they don't remember. Other clients interviewed indicate staff are nice and "they're good." C1 also wrote a note indicating "everything is going to be a good day and just wanted to be talked to" with regard to the allegation. REPORT CONTINUED ON LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME:
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
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 2
Control Number 29-AS-20220613090428
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: PEOPLE'S CARE HOWE
FACILITY NUMBER: 565802463
VISIT DATE: 06/21/2022
NARRATIVE
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Staff interview revealed that C1 picks a staff and makes complaints about that staff. This is a documented pattern of behavior C1 has. No staff interviewed have ever witnessed or heard any staff speak inappropriately to clients. Therefore, based on interview and record review, the allegation that "staff speaks inappropriately to client" is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of the report was provided via email.
SUPERVISORS NAME:
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2