Complaint Investigation Report

for Resident #1 and (former) Resident #2; Facility Staff & Residents' Rosters, Unusual Incident/Injury Reports (dated 12/28/21 and 12/29/21) with Administrator Self-reported SOC 341 (dated 12/28/21), and Pasadena Police Department Report & SOC 341 (dated 12/28/21).

Regarding Allegation #1 : this investigation revealed that local law enforcement responded to the facility regarding an aggressive act to another client that occurred on 12/27/21 (approximately) 10:00 p.m. The incident was captured on surveillance video. Client #1 was standing in the common area watching a movie and Client #2 told the client to go outside. Client #1 declined and Client #2 began to mumble then without hesitation punched Client #1 in the face (using a closed right fist) and caused a laceration to Client #1's lip. Client #1 stated that an attempt to look for a staff member after the incident happened, the client was unable to locate anyone. Client #1 waited until the next morning (12/28/21) and told the Asst. Administrator (A2) Estefany Lopez. A2 stated that Client #1 came to her in the morning of 12/28/21 and told her of the incident. A2 administered first aid to Client #1's lip. A2 spoke to Client #2 who admitted to punching Client #1 in the face. A2 contacted local law enforcement and showed them the surveillance footage of the incident. Resident #2 was released on a misdemeanor citation and was later moved to a higher level of care facility. Co-Owner/Acting Administrator, Tricia Pedroza made all the appropriate notifications to the allied agencies (via LIC 624 and SOC 341) on 12/28/21.

Based on the evidence gathered, surveillance video footage, interviews conducted and records reviewed, the preponderance of evidence standard has been met; therefore, the allegation of NEGLECT/LACK OF SUPERVISION: Resident was physically assaulted by another resident at the facility is found to be SUBSTANTIATED.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiency was observed and citation issued (ref. LIC 9099D).

An exit interview has been conducted and a copy of the Complaint Report and Appeal Rights were provided to Tricia Pedroza, Co-Owner/Acting Administrator.