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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197604989
Report Date: 01/26/2023
Date Signed: 01/26/2023 03:43:30 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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/14/2022 and conducted by Evaluator Angela Panushkina
COMPLAINT CONTROL NUMBER: 31-AS-20220714125059
FACILITY NAME:DURANDO HOME IIFACILITY NUMBER:
197604989
ADMINISTRATOR:JAMES DURANDOFACILITY TYPE:
740
ADDRESS:38757 37TH STREET EASTTELEPHONE:
(661) 266-0551
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:4CENSUS: 4DATE:
01/26/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:James Durando, AdministratorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Resident sustained bruises while in care
Staff do not properly supervise residents
INVESTIGATION FINDINGS:
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At approximately, 11:00am Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced subsequent complaint visit to deliver the final findings of the above listed allegations. LPA met with the Administrator and expained the reason for the visit.

LPA conducted a physical plant walk through, at approximately 11:15am, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. LPA did not observe any immediate health and safety issues during the visit.

On 07/15/22 an initial visit was conducted by LPA Panushkina. During that visit LPA conducted interviews with the, Administrator, House manager, 1 out of 4 staff, 3 out of 3 residents and reviewed facility records. LPA also obtained copies of pertinent documents relevant to the investigation. In addition, on 07/16/22 LPA contacted the Adult Day Program (ADP) and interviewed the Director and the Nurse. LPA requested documents from ADP pertaining to this investigation. Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
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 2
Control Number 31-AS-20220714125059
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: DURANDO HOME II
FACILITY NUMBER: 197604989
VISIT DATE: 01/26/2023
NARRATIVE
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On 07/16/22 LPA received and reviewed the documents.

Allegation: Resident sustained bruises while in care
Interviews with the Administrator and a House Manager, during the initial visit, revealed that the facility has four (4) staff members. Administrator stated: "My staff provides great care to all of my clients and I know that my residents get along with all caregivers." Administrator and the House Manager informed LPA that they haven't seen bruises on all three (3) residents arms and legs from 06/01/22 to 07/15/22. Interview with Staff #1 (S1) revealed that they love taking care of Resident #1 (R1), Resident #2 (R2) and Resident #3 (R3). S1 also informed LPA that they haven't seen anything unusual within the last seven (7) weeks. Interview with the Adult Day Care staff (conducted on 07/16/22) revealed that on 06/06/22 R2 had a skin abrasion below left knee (due to fall). LPA also was informed that no unusual bruises were noted on R2 and R3 during the morning assessments at ADP from 06/01/22 to 07/15/22. Based on the information obtained through interviews, LPA observation and document reviews this allegation is deemed Unsubstantiated.

Allegation: Staff do not properly supervise residents
Interviews with the Administrator, House Manager and S1 revealed that the facility has four (4) staff members covering each shift and the staff is always there to supervise and assist all residents. LPA was informed that between the shift changes, the staff members briefly communicate and update the next personnel regarding unusual incidents (if any) and the Administrator will be notified, immediately. Based on the information obtained through interviews and LPA observation this allegation is deemed Unsubstantiated
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2