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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005403
Report Date: 05/24/2024
Date Signed: 05/24/2024 04:24:47 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/17/2024 and conducted by Evaluator Claudia Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240517162258
FACILITY NAME:ST. ANDREWS HOME FOR THE AGEDFACILITY NUMBER:
306005403
ADMINISTRATOR:VALENCIA, VICTORIAFACILITY TYPE:
740
ADDRESS:8791 ST. ANDREWS AVENUETELEPHONE:
(714) 496-8302
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY:6CENSUS: 6DATE:
05/24/2024
UNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Victoria ValenciaTIME COMPLETED:
04:40 PM
ALLEGATION(S):
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Facility staff prevented clients from seeking medical care
Facility staff yell at clients
Facility staff behave inappropriately with clients
INVESTIGATION FINDINGS:
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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegations mentioned above. LPA met with Administrator (AD) Victoria Valencia and explained the purpose of the inspection.

Interviews were conducted with five facility staff, five residents, and two witnesses, regarding the allegation, facility staff prevented clients from seeking medical care. Five out of five staff interviewed denied having any knowledge of staff preventing residents from seeking medical care and stated residents are allowed and able to seek and receive care services. Four out of five residents stated they are allowed to seek medical care and other care services and staff assist them in attaining these services. One out of five residents was unable to confirm or deny allegation due to being non-verbal. During their interview, both witnesses stated medical and other care services are made available to residents as necessary and stated they have no knowledge of these services ever being denied. (Cont. LIC9099-C)

Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
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 22-AS-20240517162258
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: ST. ANDREWS HOME FOR THE AGED
FACILITY NUMBER: 306005403
VISIT DATE: 05/24/2024
NARRATIVE
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Interviews were conducted with five facility staff, five residents, and two witnesses, regarding the allegation, facility staff yell at clients. Five out of five staff interviewed denied personally yelling at residents and denied witnessing any other staff yelling at residents. Four out of five residents denied staff yell at them or other residents. One out of five residents was unable to confirm or deny allegation due to being non-verbal. During their interview, both witnesses denied witnessing staff yelling at residents.

Interviews were conducted with five facility staff, five residents, and two witnesses regarding the allegation, facility staff behave inappropriately with clients. Five out of five staff interviewed denied personally behaving inappropriately with residents and denied witnessing any other staff behaving inappropriately with residents. Three out of six residents denied staff behave inappropriately with them and denied witnessing staff behaving inappropriately with other residents. Two out of five residents were unable to confirm or deny allegation. During their interview, both witnesses denied witnessing or having knowledge of staff behaving inappropriately with residents.

Due to conflicting information received during interviews conducted, LPA is unable to determine if facility staff prevented clients from seeking medical care, if facility staff yell at clients, or if facility staff behave inappropriately with clients. Although the above 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 at this time the above allegations are unsubstantiated.

An exit interview was conducted and copy of this report was provided at the end of the inspection.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2