565802463-11-22-2022-29-AS-DPEA-CLNNMV-20221130093547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802463
Report Date: 11/22/2022
Date Signed: 11/22/2022 02:50:06 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
11/03/2020 and conducted by Evaluator Kelly Dulek

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20201103125214

FACILITY NAME:	PEOPLE'S CARE HOWE		FACILITY NUMBER:	565802463
ADMINISTRATOR:	RICHARD RUBIO		FACILITY TYPE:	735
ADDRESS:	3851 HOWE RD		TELEPHONE:	(805) 398-5096
CITY:	FILLMORE	STATE: CA	ZIP CODE:	93015
CAPACITY:	6	CENSUS: 5	DATE:	11/22/2022
		UNANNOUNCED	TIME BEGAN:	10:27 AM
MET WITH:	Tanya Kramer/Belen Gutierrez		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Client is not afforded dignity and respectful relationship with staff member
Facility staff restrict clients' personal relationships
Facility staff do not follow client's behavior plan

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted a subsequent complaint investigation with the purpose of delivering findings for the allegations listed above. LPA arrived at the facility at 10:27AM and met with Administrator Tanya Kramer. Entrance interview conducted.

During today’s visit, LPA toured the facility at 11:20AM with the Administrator. Previously, on 11/09/2020, LPA Dulek and Tri-Counties Regional Center (TCRC) Quality Assurance Specialist (QA) Liz Aced-Arnett conducted a telephone interview with the lead staff at 9:06am and again at 11:55am, a video call at 12:28pm which consisted of a virtual tour of the facility’s indoor space, and interview with facility designee throughout the telephonic and video visit, and LPA requested copies of pertinent documents.Then throughout the course of the investigation, LPA and QA interviewed multiple staff and clients over the telephone and LPA reviewed pertinent documents. The following was then determined:
Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

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-20201103125214

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: PEOPLE'S CARE HOWE	FACILITY NUMBER: 565802463
	VISIT DATE: 11/22/2022

NARRATIVE

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Regarding the allegation "Client is not afforded dignity and respectful relationship with staff member:"
LPA interviewed Client #1 (C1), whom the complaint references. C1 did indicate there are certain night staff who are "not nice" to them and "egg me on." When LPA asked what specifically these staff do, C1 was unable to indicate specific things the staff had said and what they were doing to "egg [C1] on." Interview with staff revealed that C1 has complained about the staff previously and that C1 has a history of making allegations against staff, which is documented in C1's file. Staff interview revealed that C1 will complain about one staff for some time, then move on and complain about a different staff member. This is a documented behavior C1 has. No staff or clients interviewed have heard staff say anything disrespectful to C1, nor has anyone interviewed witnessed C1 not being afforded dignity. When re-interviewed during a subsequent non-related visit at the facility, C1 indicated they felt safe in the facility and the staff are nice. LPA did note that most of the staff currently working at the facility now were not working at the facility when the complaint was made in November 2020. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore the allegation that "client is not afforded dignity and respectful relationship with staff member" is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Facility staff restrict clients' personal relationships:"
The complainant alleged that staff prevent C1 from having a personal relationship with Client #2 (C2). LPA interviewed C1 regarding the complaint, but C2 was unable to be interviewed, as C2 had moved out of the facility by the time the complaint was made. C1 did indicate the staff wanted to keep C1 away from C2, but also C1 indicated C2 was their "boyfriend." Staff interview revealed that C1 does have a 1:1 staff, who stays with C1 at all times. Staff indicated that C1 interacts with other clients in the home and is able to talk in common areas to whomever they choose. However, C1 does require 24 hour 1:1 supervision and therefore is unable to be completely alone with C2. Interview with clients revealed they feel they can be friends with or have personal relationships of their choosing. C1 also reported they have friends in the home and at the Licensee's other nearby facility as well. Although the allegation may be valid, at this time there is insufficient evidence to prove the allegation or that a violation occurred, therefore the allegation "facility staff restrict clients' personal relationships" is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Facility staff do not follow client's behavior plan:"
During the course of the investigation, LPA reviewed behavior plans for 3 of the 5 total clients in the facility.Report continued on LIC 9099-C

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20201103125214

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: PEOPLE'S CARE HOWE	FACILITY NUMBER: 565802463
	VISIT DATE: 11/22/2022

NARRATIVE

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Documents reviewed were up to date and provided individualized plans for each individual client. Documents indicated what types of interventions are appropriate based on behaviors for each individual in the home. Additionally, LPA was provided a plan that all staff are trained on which includes when to call the crisis team, when behavior intervention is appropriate and when law enforcement involvement may be necessary. Interviews conducted revealed that the crisis team has been called during behavior incidents at the facility, sometimes the crisis team has visited the facility in person and other times a phone call is made. Depending on the client and the behaviors the client is engaging in at the time of the call, the crisis team have informed the facility staff to call the police, while other times the behaviorist is able to speak to the client on the phone and de-escalate the behavior. Interviews with staff revealed that depending on the behavior, sometimes a different staff will try engaging with a client, other times the client refuses to speak to the behaviorist. At times, the staff will need to put a client in a CPI hold, if they are in danger of harming themselves or others. Therefore, although the allegation may be valid, at this time there is insufficient evidence to prove the allegation or that a violation occurred, as thus, the allegation that "facility staff do not follow client's behavior plan" is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of the report was provided via email.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC9099 (FAS) - (06/04)

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