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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006122
Report Date: 08/14/2025
Date Signed: 08/14/2025 02:51:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
07/17/2024 and conducted by Evaluator Ruth Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20240717155023
FACILITY NAME:EUROPEAN CHRISTIAN HOME IVFACILITY NUMBER:
306006122
ADMINISTRATOR:TRICE, THOMASFACILITY TYPE:
740
ADDRESS:980 FLAMINGO WAYTELEPHONE:
(562) 397-2591
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:6CENSUS: 6DATE:
08/14/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:ThomasTriceTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Resident sustained a fall resulting in a fractured hip, and the staff did not seek medical attention in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegation. LPA arrived at facility and was greeted at the door by staff and granted entry. LPA spoke with Thomas Trice, Administrator and explained the purpose of the visit.

The complaint was investigated by the Department. Findings are based upon this investigation which included interviews with 3 staff, a resident and 2 witnesses and the following records review: Providence St. Jude Hospital dated September 10, 2024, United Integrity Home Health dated October 4, 2024, and resident’s facility file.

It is alleged resident sustained a fall resulting in a fractured hip, and the staff did not seek medical attention in a timely manner. Interview with staff (S1 & S2) stated on July 13, 2024 around 4:00pm resident (R1)
Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
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-20240717155023
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: EUROPEAN CHRISTIAN HOME IV
FACILITY NUMBER: 306006122
VISIT DATE: 08/14/2025
NARRATIVE
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was in their room sitting in their recliner watching television. S1 and S2 were preparing for dinner when they heard a scream coming from R1’s bedroom. Staff immediately rushed to R1’s bedroom and found R1 on the floor with their head facing the bedroom doorway. S2 assessed R1 for any injuries and noted there were no visible signs of bruising. R1 stated they were fine and had no pain. Staff suggested for R1 to go to hospital for further evaluation, however R1 declined further medical attention. Staff monitored R1 in case they didn’t have any delayed pain. On the morning of July 14, 2024, around 8:45am staff checked in on R1 and R1 complained of pain to their upper left thighs. R1’s POA decided to call 911 to transfer R1 to the hospital at that time. Record review revealed that united Home Health was notified of the fall and due to R1 refusing further medical care doctor ordered mobile x-rays to be done. Records from Providence St. Jude revealed when R1 was picked up by medics and when arrived at hospital there was no visible bruising or deformity on left hip. Based on the information gathered during the investigation, there was not enough evidence to support the allegation.

Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.

An exit interview was conducted with Administrator and a copy of this LIC9099 report was left at facility.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Ruth Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2