Complaint Investigation Report

197608661-9-29-2022-29-AS-JAPL-CJY39K-20221006180318

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD. #250

This is an official report of an unannounced visit/investigation of a complaint received in our office on

09/22/2022 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20220922141140

Licensee failed to follow the facility's Plan of Operation

Licensing Program Analyst (LPA) Ashley Smith conducted an unannounced 10-day complaint visit for the above allegation. The LPA spoke with Administrator Brandy Maynard explained the reason for the visit. Today, the LPA interviewed staff at 9:15 a.m. and obtained documents.

It was alleged that this facility failed to ensure there was a licensed staff for every shift, per the facility’s program design. It was also alleged that staff failed to have proper training certifications prior to providing care to clients. Interviews and documentation confirmed that Staff #1 (S1) is the only licensed staff in the facility at this time. Given that, S1 is unavailable to work every shift and covers evening and weekend shifts. In addition, staff confirmed that Staff #2 (S2) did not have Direct Support Professional (DSP) II certification prior to hire, as detailed in the facility’s program design. The Administrator confirmed there was a staffing shortage and have since implemented a plan to ensure sufficient coverage, as well as a plan to ensure staff have the mandatory training completed as required prior to employment. Therefore, this allegation is deemed Substantiated at this time. Deficiencies cited (See 9099-D). Exit interview conducted. Copy of report and appeal rights issued.