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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015600538
Report Date: 03/16/2023
Date Signed: 03/16/2023 12:41:01 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
03/06/2023 and conducted by Evaluator Kelly Nguyen
COMPLAINT CONTROL NUMBER: 15-AS-20230306170222
FACILITY NAME:GOD'S GRACE IIFACILITY NUMBER:
015600538
ADMINISTRATOR:ISABELO C REMIGIOFACILITY TYPE:
735
ADDRESS:8497 GALINDO DRIVETELEPHONE:
(925) 828-0452
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:6CENSUS: 4DATE:
03/16/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Isabelo C. Remigio, AdminstratorTIME COMPLETED:
12:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff abused client by hitting the stomach.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/16/2023 at 10:00 AM, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct complaint investigation for the above allegations. LPAs met with Administrator Isabelo Remigio and explained the purpose of the visit.

During the course of the investigation, LPAs obtained, reviewed clients IPP, contact information, hospital records and progress notes. LPA interviewed S1, S2, and S3, C1, C2 and C3. It was alleged staff abused client by hitting the stomach. However, based on information obtained, and interviews of C1’s, C1’s Regional Center of the East Bay Case Manager, S1, S2, S3 and Social worker. C1’s doesn’t like to stay at the facility and wants to go home. C1’s likes make up stories to be sent to the hospital, also C1’s likes to accused others of abusing C1’s if C1 doesn’t get what C1’s wants.

Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted and a copy of this report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
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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