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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015600304
Report Date: 08/04/2022
Date Signed: 08/04/2022 01:36:26 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, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/18/2020 and conducted by Evaluator Laura Hall
COMPLAINT CONTROL NUMBER: 15-AS-20200618120939
FACILITY NAME:QUAIL GARDENFACILITY NUMBER:
015600304
ADMINISTRATOR:PEACOCK, ALICIAFACILITY TYPE:
740
ADDRESS:813 SOUTH J STREETTELEPHONE:
(925) 449-4411
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:20CENSUS: 17DATE:
08/04/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Alicia Peacock, AdministratorTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Resident denied phone call.
INVESTIGATION FINDINGS:
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On 8/4/2022 at 09:45AM, Licensing Program Analysts (LPAs )L. Hall and C. Fowler arrived unannounced to conduct an complaint investigation and deliver complaint findings for the allegation above. LPA met with Caregiver, Kyle Cross and explained the reason for visit. Administrator, Alicia Peacock arrived at 10:05AM.

During the the course of the investigation LPA G. Luk interviewed S1. LPAs L. Hall and C. Fowler interviewed S1, three (3) residents, obtained and reviewed the following documents: facility roster, staff roster, incident reports, police reports, care notes, court document, and email to families. On the allegation resident denied phone call, LPAs collected email that was sent to the families on 4/17/2020. The email was sent to encourage families to make calls during a certain time and a time limit so that everyone that did not have a personal phone were able to speak with their families.
Continued on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022
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 15-AS-20200618120939
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: QUAIL GARDEN
FACILITY NUMBER: 015600304
VISIT DATE: 08/04/2022
NARRATIVE
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Continued from LIC9099.

The three (3) residents that were interviewed all had their own personal phone to use. R2 stated that if her family was not able to reach her on her personal phone they would call the facility, staff would advise there is a personal phone call, and there was never a problem with using the facility's phone.

S1 stated that R1 was not denied a phone call, but requested calls be made during the time the email stated.

Based upon interviews and record review during investigation, the above allegation is unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2