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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005436
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:39:39 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
03/05/2024 and conducted by Evaluator Claudia Gutierrez
COMPLAINT CONTROL NUMBER: 22-AS-20240305162008
FACILITY NAME:VICTORIA VILLA HOMEFACILITY NUMBER:
306005436
ADMINISTRATOR:OLTEANU, CLAUDIAFACILITY TYPE:
740
ADDRESS:11132 FRALEY STREETTELEPHONE:
(949) 232-9619
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY:6CENSUS: 6DATE:
04/23/2024
UNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Edna JoseTIME COMPLETED:
03:55 PM
ALLEGATION(S):
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Staff are verbally abusing clients.

Staff are restricting a client from participating in activities.
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 for the purpose of delivering findings. LPA met with Staff Edna Jose and explained the purpose of the inspection.

Interviews were conducted with three facility staff, Resident 1 (R1) and two additional facility residents regarding the allegation staff are verbally abusing clients. Per Reporting Party (RP) verbal abuse consisted of staff making comments regarding R1’s body and weight. Three out of three staff interviewed denied personally verbally abusing residents, including R1 and denied witnessing any other staff verbally abusing residents or making comments about R1’s body or weight. During their interview, R1 denied staff ever made comments about their body or weight. Two out of two additional residents interviewed were unable to corroborate allegation and stated they enjoy the facility staff. (Cont. LIC9099-C)
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
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-20240305162008
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: VICTORIA VILLA HOME
FACILITY NUMBER: 306005436
VISIT DATE: 04/23/2024
NARRATIVE
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Interviews were conducted with three facility staff, R1, and two additional facility residents regarding the allegation staff are restricting a client from participating in activities. Three staff out of three staff interviewed denied personally restricting residents from participating in activities and denied having knowledge of any other staff restricting residents from participating in activities. R1 also denied activities being restricted or withheld by staff and stated they were allowed to freely engage in activities of preference. Per R1, making jewelry with beads, arts and crafts, and bubbles are their preferred activities and stated they were allowed to freely engage in these activities at the facility at their own leisure. One out of two residents interviewed could also not corroborate the allegation and were unable to confirm or deny if staff restrict participation in activities, but stated they attend day program regularly. One out of two residents stated they have a big screen television and surround sound in their bedroom that was installed by staff, and stated they are able to engage in this preferred activity freely.

Due to allegations being uncorroborated during interviews conducted, LPA is unable to determine if staff are verbally abusing clients or if staff are restricting a client from participating in activities. 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: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2