019200464-5-20-2021-15-AS-KHOS-C3CJNR-20210525071221

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200464
Report Date: 05/20/2021
Date Signed: 05/20/2021 06:06:48 PM

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
05/20/2020 and conducted by Evaluator Praveen Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20200520135819

FACILITY NAME:	J & C CARE CENTER LLC		FACILITY NUMBER:	019200464
ADMINISTRATOR:	CHING, JESSICA		FACILITY TYPE:	740
ADDRESS:	4240 REDDING STREET		TELEPHONE:	(510) 482-0108
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94619
CAPACITY:	25	CENSUS: 21	DATE:	05/20/2021
		UNANNOUNCED	TIME BEGAN:	05:40 PM
MET WITH:	Jessica Ching, Administrator		TIME COMPLETED:	06:00 PM

ALLEGATION(S):

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9

-Facility failed to prevent the spread of scabies.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Praveen Singh conducted this inspection with Administrator Jessica Ching to deliver findings on the above allegation. Due to the present shelter in place order by the Governor, this inspection was conducted via video-conference.

It was alleged that R1 contracted scabies and the facility failed to follow proper communicable disease protocol and procedures in order to stop the spread of scabies. During the investigation, LPA conducted interviews and reviewed records relating to the allegation. Based on information gathered, there was not a substantial amount of evidence to support the allegation and no independent evidence or witnesses could be obtained to support that the facility failed to take appropriate action to prevent a scabies outbreak.

Based on the investigation, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided via email.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Praveen Singh	TELEPHONE: (510) 622-2625
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021

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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