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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200543
Report Date: 04/22/2025
Date Signed: 04/22/2025 12:18:56 PM

Substantiated


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
12/13/2024 and conducted by Evaluator Alicia Delmundo
COMPLAINT CONTROL NUMBER: 15-AS-20241213155842
FACILITY NAME:WORTHY HOUSE #1FACILITY NUMBER:
019200543
ADMINISTRATOR:DAPHNA GARCIAFACILITY TYPE:
735
ADDRESS:568 MEEK AVENUETELEPHONE:
(510) 583-1160
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY:6CENSUS: 2DATE:
04/22/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Daphna Garcia/AdministratorTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Licensee violated client's personal rights.
INVESTIGATION FINDINGS:
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On this day, 4/22/25, at 11:00 a.m., Licensing Program Analyst (LPA) Delmundo conducted an unannounced visit to deliver findings for the above allegation. LPA met with Daphna Garcia, administrator. LPA called and spoke over the phone with Kim Fields, licensee. LPA informed the reason for visit.

During the course of investigation, the Department obtained copies of staff schedule and following clients' documents: LIC601 Identification and Emergency Contact Information; LIC602 Physician's Report; Individual Program Plan; Quarterly Report; Special Incident Report. The Department interviewed the clients (C1, C2) on 12/18/24, 12/23/24 and 1/14/25, staff (S2) on 1/14/25 , staff (S3) on 2/20/25, and licensee on 1/14/25. The client’s family member (FM) was also interviewed on 12/17/24.

The reporting party stated the that the licensee broke into client's room (C1) and threw C1’s clothes out. Co-reporting party reported that clients are not allowed to eat in their rooms.
........continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 7
Control Number 15-AS-20241213155842
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: WORTHY HOUSE #1
FACILITY NUMBER: 019200543
VISIT DATE: 04/22/2025
NARRATIVE
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C1 stated that the licensee wants the key to her room but C1 didn’t want her to come inside the room. C1 further stated that the licensee went in and threw C1’s clothes out from the drawer to the bed and cleaned C1’s closet.

FM stated that C1 was upset and told FM that C1’s room was locked, and that the licensee broke into C1’s room using a credit card to open the door. The licensee threw C1’s clothes from the drawer to C1's bed. FM further stated that she called the staff to confirm the incident.

S2 confirmed that C1 didn’t want to give the key to C1’s room and somehow, the licensee and S1 were able to get inside and cleaned C1’s room.

Both C1 and C2 stated that the licensee told them not to eat in their rooms.

Based on interviews conducted, the preponderance of evidence has been met, therefore the allegation is substantiated. Deficiency is cited from Title 22 California Code of Regulations and listed on 9099D. Failure to submit proof of correction by plan of correction due date and any repeat violation within 12 month period may result in civil penalty.

Deficiency and plan and proof of correction were discussed with the licensee over the phone and with the administrator.

Exit interview conducted. Appeal Rights, LIC9098 Proof of Correction form and copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 15-AS-20241213155842
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: WORTHY HOUSE #1
FACILITY NUMBER: 019200543
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/06/2025
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights
(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
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Licensee to read and comply with the Regulations. Self-certification to be submitted by 5/06/25.
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-This requirement is not met as evidenced by:

-Based on interviews, the licensee did not comply with the section above for the following: (1) C1's room was opened without C1's permission; (2) C1 and C2 not allowed to eat in their rooms
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7
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
12/13/2024 and conducted by Evaluator Alicia Delmundo
COMPLAINT CONTROL NUMBER: 15-AS-20241213155842

FACILITY NAME:WORTHY HOUSE #1FACILITY NUMBER:
019200543
ADMINISTRATOR:DAPHNA GARCIAFACILITY TYPE:
735
ADDRESS:568 MEEK AVENUETELEPHONE:
(510) 583-1160
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY:6CENSUS: 2DATE:
04/22/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Daphna Garcia/AdministratorTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Licensee is encouraging client to participate in sexual activity.

Facility did not provide care and supervision to clients.
INVESTIGATION FINDINGS:
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On this day, 4/22/25, at 11:00 a.m., Licensing Program Analyst (LPA) Delmundo conducted an unannounced visit to deliver findings for the above allegation. LPA met with Daphna Garcia, administrator. LPA called and spoke over the phone with Kim Fields, licensee. LPA informed the reason for visit.

During the course of investigation, the Department obtained copies of staff schedule and the following clients' documents: LIC601 Identification and Emergency Contact Information; LIC602 Physician's Report; Individual Program Plan; Quarterly Report; Special Incident Report. The Department interviewed the clients (C1, C2) on 12/18/24, 12/23/24 and 1/14/25, staff (S2) on 1/14/25, staff (S3) on 2/20/25 and licensee on 1/14/25. The following were also interviewed: family member (FM) on 12/17/24; RCEB case manager (CM) on 12/20/24; day program staff (W1) on 12/24/24.

.....continued on 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 15-AS-20241213155842
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: WORTHY HOUSE #1
FACILITY NUMBER: 019200543
VISIT DATE: 04/22/2025
NARRATIVE
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Allegation: Licensee is encouraging client (C1) to participate in sexual activity.
The RP stated that the licensee is bringing C1 to licensee’s home to have sexual activities with men the licensee invites. FM stated that licensee might be prostituting C1 in exchange for money. FM stated that C1’s phone showed several unknown numbers on the call log and when asked, C1 told FM that licensee calls her for work.

W1 stated C1 has not made any unusual disclosure about any issues living at the facility or concerns about C1’s sexual activities. CM stated C1 is not conserved, has history of behavior issues and inappropriate behaviors. CM also stated that C1 can consent to sexual activity and that there was no complaint about sexual conduct or sexual relationships at the licensee’s house or facility. CM was previously told that C1 voluntarily visited the licensee’s house; however, during meeting on 12/19/24, FM stated that C1 never wanted to go and that the visit was not consensual.

C1 stated the licensee brings men into C1’s room. C1 provided mixed statements and was unable to provide last names for the men she provided during interview. C1 told the men not wanting to have sex with them; however, C1 later changed the statement. C1 stated men came to the facility and they would have sex in C1’s room.

S2 stated C1 does not have job but C1 sometimes goes to the licensee’s house to clean for money and has not heard if C1 was meeting any men at the licensee’s house. S2 also stated that clients are allowed to have guests and that there’s no rules against client’s guest sleeping over, but the clients have to let the staff know. C1 has brought male guest over and is good in letting the staff know. C1 had male guests, and all the sexual encounters were consensual. S2 further stated that the complaint started in December 2024 when FM brought a puppy to the facility for C1, and the licensee granted permission to have the puppy at the facility. The licensee later changed her mind in having the puppy at the facility, so the puppy was adopted by the staff. C1 will try to see the puppy even at times when S2 or S3 is not available and C1 would get upset and would make false claims/complaints to FM.

.....continued on 9099C
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 15-AS-20241213155842
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: WORTHY HOUSE #1
FACILITY NUMBER: 019200543
VISIT DATE: 04/22/2025
NARRATIVE
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S3 stated that whenever C1 wants to earn money, C1 would go to the licensee’s house to clean but S3 does not know if C1 is meeting anyone or met anyone romantically while at the licensee’s house. S3 also stated that C1 is sexually active and that clients have personal rights to have guests at the facility. C1 would have guests and have consensual sexual activities.

The licensee denied the allegation and does not know why she would be accused of soliciting C1. She stated that C1 is independent and come and go as she wants and has had relationships with men in the past. C1 has boyfriend who picks up and drives C1 from the facility. She further stated that she does not like that clients can have guests because they are not fingerprint cleared and that clients could be bringing any stranger into the facility, but the clients have personal rights to have guests and engage in sexual intimacy. She also stated that C1 used to come to her house to clean for extra money but when allegation began, she stopped offering C1.

Based on information obtained, the preponderance of standard is not met, therefore, the allegation is unsubstantiated.

Allegation: Facility did not provide care and supervision to clients.
The RP stated that on 12/07/24, the clients were left alone at the facility without supervision and no staff present. It was further alleged that around October 2024, the licensee took clients out of state and client (C1) took care of the other client (C2).

C1 and C2 stated they were never left alone in the facility. C1 stated she assisted C2 when they went out of state with the license; however, when verified, C1 stated she just walked C2 to the bathroom and never assisted C2 with activities of daily living (ADLs).


........continued on 9099C
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 15-AS-20241213155842
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: WORTHY HOUSE #1
FACILITY NUMBER: 019200543
VISIT DATE: 04/22/2025
NARRATIVE
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S2 stated the clients were never left alone in the facility. S3 stated that if she and S2 are not scheduled on weekends, it is the licensee who works.

Based on information obtained, the preponderance of standard is not met, therefore, the allegation is unsubstantiated.

An unsubstantiated findings means that although the allegations may have happened or are valid, the preponderance of evidence standard has not been met.

No deficiency cited.

Exit interview conducted and copy of this report provided.
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 7