019200186-1-2-2025-15-AS-HHUL-DDTLA2-20250212073421

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200186
Report Date: 01/02/2025
Date Signed: 01/02/2025 03:25:52 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
10/30/2024 and conducted by Evaluator Grace Luk

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20241030163407

FACILITY NAME:	MCHAROLD HOME		FACILITY NUMBER:	019200186
ADMINISTRATOR:	LORNA A.HAYAG		FACILITY TYPE:	735
ADDRESS:	1076 EL DORADO DRIVE		TELEPHONE:	(925) 245-0779
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94550
CAPACITY:	6	CENSUS: 5	DATE:	01/02/2025
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Lorna Hayag, Administrator		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Staff physically abused client(s) in care

INVESTIGATION FINDINGS:

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On 1/2/2025 at 2:15PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct complaint investigation and deliver findings in regards to the allegation above. LPA met with Administrator, Lorna Hayag and informed her the reason for visit.

During the course of investigation, LPA interviewed 3 clients, 5 staff, 3 witnesses, and complainant. LPA obtained and reviewed documents including physician's report, IPP, ISP, dangerous propensity, and emergency information. Interview with staff and witnesses indicated no staff hit clients. W3 stated that C1 gets along with staff and clients at the facility. W2 stated that C1 creates fantasy and doesn't always provide accurate information. C1's ISP indicated that C1 has a history of making false statements. Interview with clients revealed that they get along with the staff at the facility.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted. A copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025

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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