198601821-5-27-2022-11-AS-MVAO-CGARGA-20220713130027

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601821
Report Date: 05/27/2022
Date Signed: 05/27/2022 04:07:39 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/14/2021 and conducted by Evaluator Martessa Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210914123058

FACILITY NAME:	TOTALCARE RESIDENTIAL INC.		FACILITY NUMBER:	198601821
ADMINISTRATOR:	FRED FLUKER		FACILITY TYPE:	735
ADDRESS:	456 W. PALMER STREET		TELEPHONE:	(626) 622-2605
CITY:	COMPTON	STATE: CA	ZIP CODE:	90220
CAPACITY:	6	CENSUS: 3	DATE:	05/27/2022
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Shainna Cato-House Manger		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Client threatened to cause harm with a firearm while in care
Staff did not address a resident's change in health condition.

INVESTIGATION FINDINGS:

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On 5/22/22, Licensing Program Analyst (LPA) Martessa Brown conducted a subsequent visit in order to render investigation findings for the above allegations. During today’s visit LPA met with Norma Galdamez Caregiver and was later met by Shainna , and the purpose of the visit was explained.

The investigation consisted of the following: On 9/15/21, Licensing Program Analysts (LPAs) Martessa Brown, Ana Soto and Investigator Douglas Real initiated a complaint visit investigation. LPAs and investigator conducted a Health & Safety check and no weapons were found on the premises. Interviews were conducted with C1, Administrator and Staff #1. LPAs attempted to interview clients #2-3 and residents were nonverbal. LPAs reviewed client C1’s file and requested the following documents: Client and staff roster, C1 IPP/Behavior plans and administrator files.

The investigation revealed the following:
9099-C is on the next page

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022

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 3

Control Number 11-AS-20210914123058

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: TOTALCARE RESIDENTIAL INC.	FACILITY NUMBER: 198601821
	VISIT DATE: 05/27/2022

NARRATIVE

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Allegation: Client threatened to cause harm with a firearm while in care.

On 9/15/21, Investigator interviewed C1 regarding the above allegation. C1 had stated was at a family members home and was accused of stealing a video game then became very upset. C1 had admitted to saying was going to shoot a family member but denied of having a gun. Investigator stated did not see any security issues and did not find a weapon. On 9/15/22 LPA’s conducted an interview with the administrator regarding the above allegation. Administrator stated social worker informed him of the incident on 9/9/21 between C1 and family member. He stated was aware of the situation but since it wasn’t at the facility, did not think he had to report. He stated officers came to the facility and searched the premises and no weapon was discovered. Also, on 9/10/21 social worker informed administrator that Social Psychiatric Mobile Response Team (PMRT) was at the facility to evaluate C1. Administrator stated was unable to leave due to C1 receiving Covid19 booster. LPA conducted an interview with Staff #1, stated was aware of the incident and did not see C1 with a gun and did not find any weapons. Social worker also stated was notified by family member that C1 was at their residence and became angry and had threaten to shoot a minor. Social Worker stated administrator refused to leave doctors appoint in the middle of C1s booster shot to be assisted by PMRT. Based on interviews conducted and observation, C1 did not have a firearm while in care.

LIC9099-C is on the next page.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 11-AS-20210914123058

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: TOTALCARE RESIDENTIAL INC.	FACILITY NUMBER: 198601821
	VISIT DATE: 05/27/2022

NARRATIVE

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Allegation: Staff did not address a resident’s change in health Condition

On 9/15/22, LPA interviewed Administrator regarding the above allegation. Administrator stated C1 doesn’t have any restrictions and can leave the facility. He stated prior to the incident, did not see any changes or had concerns with C1 health condition. C1 has not been receiving services from Regional Center due to being a non-minor dependent and is limited on services and behavior plans. He stated C1 is still under children services but is in the process of being transfer to South Central Regional Center and has been communicating with family children services. LPA’s interviewed S1, regarding the above allegation. S1 stated there has been no change in C1 health condition. Interview conducted with social worker stated C1 is going to be receiving services from regional center to address his behavior issues. LPA reviewed C1s Individual Plans and Family services agreements and meetings have been on going.

Based on interviews conducted and records review, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted with, and a hard copy was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Martessa Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2022

LIC9099 (FAS) - (06/04)

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