565802463-12-16-2022-29-AS-JAPL-CMJ3AB-20221227170427

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802463
Report Date: 12/16/2022
Date Signed: 12/16/2022 04:29:32 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
10/25/2022 and conducted by Evaluator Angel Ascencio

COMPLAINT CONTROL NUMBER: 29-AS-20221025104736

FACILITY NAME:	PEOPLE'S CARE HOWE		FACILITY NUMBER:	565802463
ADMINISTRATOR:	CARLOS MARCIA		FACILITY TYPE:	735
ADDRESS:	3851 HOWE RD		TELEPHONE:	(805) 398-5096
CITY:	FILLMORE	STATE: CA	ZIP CODE:	93015
CAPACITY:	6	CENSUS: 5	DATE:	12/16/2022
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Tanya Kramer		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility does not have enough food for residents in care
Facility does not have enough hygiene products for resident in care
Residents not awarded privacy

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angel Ascencio conducted a subsequent complaint visit to the above facility to deliver final findings. LPA Ascencio met with Administrator Tanya Kramer at 1:20 p.m. Entrance interview conducted.

On 10/25/2022, the Department received a complaint regarding facility does not have enough food for residents in care, facility does not have enough hygiene products for resident in care, and residents not awarded privacy. On 10/18/2022 starting at 12:35 p.m., LPA Ascencio conducted a required Annual visit to the facility. LPA observed a staff closet that contained multiple hygiene products such as deodorant, shampoo, conditioner, toilet paper and hand soaps. Later that same day, continuing the facility’s Annual visit, LPA Ascencio observed sufficient amounts of perishable and nonperishable food items in a kitchen cabinet and refrigerator.

Continued on LIC 9099 - C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angel Ascencio
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

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-20221025104736

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: 12/16/2022

NARRATIVE

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On 11/04/2022, starting at 9:46 a.m., interview with Staff #1 (S1) revealed that all hygiene products and grocery shopping are done once a week on Monday or Tuesday. S1 also stated they have never run out of food or hygiene products. S1 stated, there have been times where we are low on hygiene products and perishable foods because it is the end of their shopping week. The following day we stock back up on items. S1 provided LPA Ascencio a copy of Grocery Log receipts for the month of October 2022. Interviews with five (5) out of six (6) clients revealed that the home has never run out of food and when they want a particular meal item, it is provided by the staff if available. Clients interviews also revealed that the home has enough shampoo and conditioner, but they are limited in the use for them because clients use too much at a time. Based on evidence gathered throughout the investigation, the allegations of facility does not have enough food for residents in care, and facility does not have enough hygiene products for resident in care is deemed unsubstantiated at this time. Regarding the allegation of resident not awarded privacy. During client interviews on 11/4/2022, 5 out of 6 clients interviews revealed that staff are nice and helpful towards the clients. Further interviews with clients revealed that staff members don’t bother the clients and when clients are in their rooms, staff knock at client’s door before entering their room. Further interviews also revealed that no one forces their way in, or barges through their door without their permission. Interview with Client #1 (C1), starting at 11:15 a.m. revealed that they like to play music very loud it is hard for them to hear the knocking at the door. C1 added that is the only time staff come into their room because they cannot hear the staff calling their name or knocking. Based on evidence gathered, the allegation residents not awarded privacy is deemed unsubstantiated at this time.

Exit interview conducted and a copy of the report provided to Administrator via email.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angel Ascencio
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

LIC9099 (FAS) - (06/04)

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