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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603344
Report Date: 02/29/2024
Date Signed: 02/29/2024 02:49:41 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/16/2023 and conducted by Evaluator Valeria Maldonado
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230816170212
FACILITY NAME:ST. JUDE'S ELDER CARE IIFACILITY NUMBER:
198603344
ADMINISTRATOR:RAGANO, SCOTTFACILITY TYPE:
740
ADDRESS:502 SOUTH DARWOOD AVENUETELEPHONE:
(909) 263-3787
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:6CENSUS: 6DATE:
02/29/2024
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Judy Ragano- Administrator and Melinda Nofuente- CaregiverTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff inappropriately touching resident.
Staff hit resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) V. Maldonado made an unannouced complaint visit at the facility for the purpose of investigating the above-mentioned alleagtions. LPA Maldonado met with Administrator Judy Ragano, and explained the purpose for the visit.

During today's visit, LPA Maldonado obtained a copy of the resident and staff roster, an incident report dated: 8/16/23 regarding Resident#1 (R1), and a copy of the following documents for R1: Facesheet, Physician's Report, and Pre-Placement Appraisal. LPA also conducted interviews with Residents#1-6 (R1-R6) and Staff#2-4 (S2-S4). LPA was unable to interview Staff#1 (S1) due to S1 no longer working at the facility.

The investigation revealed the following:

(Report continued on LIC9099-C...)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Valeria Maldonado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
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 28-AS-20230816170212
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: ST. JUDE'S ELDER CARE II
FACILITY NUMBER: 198603344
VISIT DATE: 02/29/2024
NARRATIVE
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Regarding allegation: Staff inappropriately touching resident.
It is alleged that on 8/14/23, a S1 pinched R1's buttocks and was "pushing" themselves onto R1 from behind. Per staff interviews conducted, (2) of (3) staff denied the allegation. (1) of (3) staff interviewed could not corroborate the allegation. S2 stated that an internal investigation was conducted by S2 and nothing was found indicating the allegation to be true. S1 was let go of their position and is no longer working here, regardless of the findings of the facility's internal investigation. Per resident interviews, (5) of (6) residents could not corroborate the allegation. R1 denied the allegation and stated S1 did not make R1 feel uncomfortable or touch R1 inappropriately. This allegation was unsubstantiated.

Regarding allegation: Staff hit resident.
It is alleged that on 8/14/23, S1 pinched and slapped R1's face. Per staff interviews, (2) of (3) staff denied the allegation. (1) of (3) staff interviewed could not corroborate the allegation. Staff stated they are professional and receive training in treating residents with dignity and respect. Per interviews conducted with residents, (5) of (6) residents could not corroborate the allegation. R1 denied the allegation and stated S1 never hit R1. This allegation is Unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Per California Code of Regulations, Title 22, and Health and Safety Code, no deficiencies were observed or cited during today's visit.

An exit interview was conducted and copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Valeria Maldonado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2