015600382-6-4-2025-15-AS-HHUL-DHCSWT-20250605141448

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 015600382
Report Date: 06/04/2025
Date Signed: 06/04/2025 01:40:09 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
06/20/2024 and conducted by Evaluator Alicia Delmundo

COMPLAINT CONTROL NUMBER: 15-AS-20240620142927

FACILITY NAME:	GOD'S GRACE		FACILITY NUMBER:	015600382
ADMINISTRATOR:	JOSEPH G CRISOL		FACILITY TYPE:	735
ADDRESS:	629 HAMPTON ROAD		TELEPHONE:	(510) 278-3607
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	23	CENSUS: 16	DATE:	06/04/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kenneth Lal/Staff		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff did not prevent resident (R1) from engaging in inappropriate interaction with another resident (R2).

INVESTIGATION FINDINGS:

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On this day, May , 2025, Licensing Program Analyst (LPA) Delmundo arrived unannounced to deliver the findings for the above allegation. LPA met with Kenneth Lal, staff, and informed the reason for visit. LPA called and left message on Joseph Crisol's (administrator-ADM) voicemail. ADM returned LPA's call at 1:21 pm.

During the course of investigation, the Department obtained copies of LIC9020 Register of Facility Clients/Residents, LIC500 Personnel Report, staff contact information and facility notes. Copies of including but not limited the following residents’ documents were also obtained: LIC601 Identification and Emergency Contact Information; LIC602 Physician's Report; Admission Agreement; LIC625 Appraisal/Needs and Services Plan; Unusual Incident Reports (UIRs); resident’s and resident’s (R2) case manager (CM) written statements. Local law enforcement was also involved in the investigation and copy of Police Report was obtained. The following were interviewed: residents (R1, R2, R3, R4) and staff (S1, S2) on 9/06/24; administrator (ADM) on 9/04/24 ........continued on 9099C (page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025

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 15-AS-20240620142927

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: GOD'S GRACE	FACILITY NUMBER: 015600382
	VISIT DATE: 06/04/2025

NARRATIVE

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S1, S2 and ADM stated residents are allowed to have romantic relationships and engage in sexual activity if it is consensual. R1 and R2 are independent and have the mental capacity to engage in sexual activity. Staff are to provide a private space for residents to engage in sexual activity if requested, and inappropriate behavior is allowed as long as both parties consent. One of the 3 staff stated that at first when R2 disclosed the 2 oral sexual encounters and asked R2 if R2 was happy, R2 stated he was; however, R2 later changed his statement that the second encounter was not consensual. S2 stated that R2 told S2 of the sexual interactions with R1 a day after talked to S1. S2 further stated that he only came to know about R2 changing his story from S1.

R1 and R2 confirmed that R2 orally copulated R1 in the bathroom on two occasions. R1 stated that R2 consented on those 2 occasions. R1’s statement was reviewed indicating there were 2 incidents of sexual encounters but not reported right away. R1 indicated that he was afraid but reported the 2^nd incident to local law enforcement, but record didn’t prove that the incident was reported.

CM’s statement indicated that R2 and CM spoke over the phone and that R2 told CM about the encounter with R1. R2 did not say it was forced; however, R2 stated he was uncomfortable about the situation. CM suggested R2 call the police and that R2 insisted he called but was turned away which CM thought that it was unusual and R2 did not provide the date it was reported.

R3 stated that R1 does not sexually harass, touch or attempt to do anything inappropriate to him nor observed R1 flirt, engage in romantic relationships, or act inappropriately with other residents. R4 stated not been harassed, flirted with, or touched inappropriately by any residents and did not observe any residents in romantic relationships or acting inappropriately with each other.

Based on all information gathered, there is not a preponderance of evidence to prove that violation occurred, therefore the allegation is closed as unsubstantiated.

No deficiency cited.

Exit interview conducted. ADM can not come to the facility to meet with LPA. AMD authorized Kenneth Lal to sign and receive this report.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025

LIC9099 (FAS) - (06/04)

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