306006153-1-24-2023-22-AS-LADS-CNF4AF-20230125175551

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006153
Report Date: 01/24/2023
Date Signed: 01/24/2023 03:26:34 PM

Unfounded

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
01/20/2023 and conducted by Evaluator Jerome Haley

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230120102448

FACILITY NAME:	CARE JANELLA		FACILITY NUMBER:	306006153
ADMINISTRATOR:	CALANGI, KARMIAN		FACILITY TYPE:	740
ADDRESS:	17072 SAGA DRIVE		TELEPHONE:	(714) 683-4617
CITY:	YORBA LINDA	STATE: CA	ZIP CODE:	92886
CAPACITY:	6	CENSUS: 3	DATE:	01/24/2023
		UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Janella Cervania		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Staff cannot effectively communicate with residents.
Staff does not clean facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jerome Haley made an unannouced visit regarding the complaint allegations listed above. LPA Haley was greeted and granted entry by staff. LPA Haley met with Licensee Janella Cervania and explained the reason for the visit.

Before getting started, Licensee Janella Cervania led LPA Haley on a tour of the facility. The interior of the facility was clean and well organized as well as the backyard area and the garage.

After the tour of the facility, LPA began interviewing facility staff and residents: Licensee Cervania, Administrator Karmian Calangi via telephone, Resident 1 (R1), Resident 2 (R2), and Resident 3 (R3) was sleeping and could not be interviewed.

Regarding the allegations: (1) Staff cannot effectively communicate with residents and (2) Staff does not clean the faciltiy

Continued on LIC9099C

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20230120102448

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: CARE JANELLA	FACILITY NUMBER: 306006153
	VISIT DATE: 01/24/2023

NARRATIVE

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Through interviews with the Licensee, Administrator, staff, and residents the investigation revealed the following:

Staff and residents communicate effectively with each other. During the time of the visit LPA Haley observed effective communication between staff and residents. LPA observed a white board in R2s room that's used to communicate with the R2 who's hard of hearing. Staff write down what they're saying and R2 will read the white board and respond. Furthermore, effective communication between residents and staff was confirmed during interviews with staff and residents.

The facility was observed to be clean and organized. At the beginning of the visit Licensee Janella and LPA Haley toured the inside, outside, and garage area of the facility. Everything was clean, and neatly organized. The bathroom areas were clean as well. Furthermore, during interviews LPA Haley received information that contradicts the allegation staff does not clean facility.

Based on the information gathered during the investigation, observation, and review of all documents obtained, the following allegations: (1) Staff cannot effectively communicate with residents and (2) Staff does not clean the facility is deemed Unfounded, meaning the allegation is false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023

LIC9099 (FAS) - (06/04)

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