019200013-1-13-2023-15-AS-BFOG-CN9VEX-20230120152305

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200013
Report Date: 01/13/2023
Date Signed: 01/13/2023 02:40:00 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
08/16/2022 and conducted by Evaluator Catherine Lin

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20220816122959

FACILITY NAME:	LIAHONA COMMUNITY CARE		FACILITY NUMBER:	019200013
ADMINISTRATOR:	TABION, RODERICK B		FACILITY TYPE:	735
ADDRESS:	34213 ARIZONA ST		TELEPHONE:	(510) 396-0850
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY:	6	CENSUS: 5	DATE:	01/13/2023
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Roderick Tabion, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff member made inappropriate comments to client while in care.
Staff member physically abused (hit and pushed) a client while in care.
Staff member threatened a client while in care.
Staff member threw a client's food away while in care.

INVESTIGATION FINDINGS:

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On 1/13/23 at 1:10 p.m., Licensing Program Analyst (LPA) Catherine Lin conducted an unannounced subsequent complaint investigation regarding the above allegations and respect to deliver investigation findings. LPA met with the Administrator and explained the purpose of the visit.

Allegation: Staff member made inappropriate comments to client while in care – Unsubstantiated.
The Department has investigated this allegation and per records review and interviews, and found that 3 clients and 3 staff stated that they have not witnessed staff made inappropriate comments to clients while in care.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Catherine Lin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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 15-AS-20220816122959

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: LIAHONA COMMUNITY CARE	FACILITY NUMBER: 019200013
	VISIT DATE: 01/13/2023

NARRATIVE

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Allegation: Staff member physically abused (hit and pushed) a client while in care – Unsubstantiated
The Department has investigated this allegation and per records review and interviews, and found that 3 clients and 3 staff stated that they have not witnessed staff hit or pushed any of client while in care. Client C2 stated that S1 hit her face one time and didn’t remember when it was happened, S1 denied, no witness was found for this incident.

Allegation: Staff member threatened a client while in care – Unsubstantiated
The Department has investigated this allegation and per records review and interviews, and found that 3 clients and 3 staff stated that they have never witnessed staff threatened any of client while in care. 3 clients who were interviewed stated that staff treated them well and respectfully. Clients were observed being happy during visits.

Allegation: Staff member threw a client's food away while in care – Unsubstantiated
The Department has investigated this allegation and per records review and interviews, and found that 3 clients and 3 staff stated that they have not witnessed staff threw away client’s food while client was eating except food got dirty or was unfinished on the plate after meal time.

Based on observation and interview conducted, the above allegations are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

No deficiency cited, exit interview conducted with Administrator, and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Catherine Lin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

LIC9099 (FAS) - (06/04)

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