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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200678
Report Date: 04/30/2025
Date Signed: 04/30/2025 01:11:08 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
01/13/2025 and conducted by Evaluator Grace Luk
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250113081445
FACILITY NAME:G.L.O.M. ARFFACILITY NUMBER:
019200678
ADMINISTRATOR:TURNER, ALLEN DRFACILITY TYPE:
735
ADDRESS:2066 WALNUT STREETTELEPHONE:
(925) 583-5775
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:6CENSUS: 6DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Latanya Austin, Program Director
Tyrone Titus, Facility Manager		TIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff uses physical forms of abuse with clients in care
Staff does not ensure clients are spoken to in an appropriate manner
INVESTIGATION FINDINGS:
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On 4/30/2025 at 10:15AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings in regards to the allegations above. LPA met with Facility Manager, Tyrone Titus and informed him the reason for visit. Program Director, Latanya Austin arrive a couple hours later.

During the course of investigation, LPA interviewed 6 clients, 4 staff, witness, and complainant. LPA reviewed and obtained documents including (staff roster with contact information, current administrator documents, utilities proof of payment, maintenance log, emergency information, physician's report, care plan, facility notes, and incident reports.

Staff uses physical forms of abuse with clients in care
Interview with clients indicated clients have either witnessed or experienced physical abuse by staff (S4) with an object (a cup) or with S4's hand. (Continue on LIC9099C...)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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 5
Control Number 15-AS-20250113081445
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: G.L.O.M. ARF
FACILITY NUMBER: 019200678
VISIT DATE: 04/30/2025
NARRATIVE
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Interview with staff and witness revealed they have witnessed staff (S4) physically abused clients. W1 stated W1 witnessed an incident where S4 hit C4 on the lip with a cup.

Staff does not ensure clients are spoken to in an appropriate manner
Interview with clients revealed that staff (including S4 and S5) have yelled at clients. Interview staff and witness indicated they have witnessed staff (S4 and S5) verbally abused clients.

Based on LPA's information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC9099D.

Exit interview conducted with Latanya Austin. A copy of this report and appeal rights provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 15-AS-20250113081445
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: G.L.O.M. ARF
FACILITY NUMBER: 019200678
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2025
Section Cited
CCR
80072(a)(3)
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Personal Rights. To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature... This requirement is not met as evidence by:
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Facility has agreed to create a plan to conduct training for staff regarding personal rights and submit plan to CCLD by POC date.
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Based on interviews, licensee did not comply with the section cited above by staff physically abuse clients which poses an immediate health and safety risk to the persons in care.
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Type B
05/16/2025
Section Cited
CCR
80072(a)(1)
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Personal Rights. To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidence by:
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Facility has agreed to conduct training for staff regarding personal rights and submit training documents to CCLD by POC date.
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Based on interviews, licensee did not comply with the section cited above by staff verbally abuse clients which poses a potential personal rights violation to the persons in care.
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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: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
01/13/2025 and conducted by Evaluator Grace Luk
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250113081445

FACILITY NAME:G.L.O.M. ARFFACILITY NUMBER:
019200678
ADMINISTRATOR:TURNER, ALLEN DRFACILITY TYPE:
735
ADDRESS:2066 WALNUT STREETTELEPHONE:
(925) 583-5775
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:6CENSUS: 6DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Latanya Austin, Program Director
Tyrone Titus, Facility Manager		TIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Licensee does not ensure the facility has a certified administrator
Staff does not ensure facility has a working telephone system
Licensee does not ensure facility maintains financial stability
Staff does not ensure first aide supplies are properly maintained
Staff does not ensure client records are properly maintained
INVESTIGATION FINDINGS:
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2
3
4
5
6
7
8
9
10
11
12
13
On 4/30/2025 at 10:15AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings in regards to the allegations above. LPA met with Facility Manager, Tyrone Titus and informed him the reason for visit. Program Director, Latanya Austin arrive a couple hours later.

During the course of investigation, LPA interviewed 6 clients, 4 staff, witness, and complainant. LPA reviewed and obtained documents including (staff roster with contact information, current administrator documents, utilities proof of payment, maintenance log, emergency information, physician's report, care plan, facility notes, and incident reports.

Licensee does not ensure the facility has a certified administrator
Record review indicated there was staff at the facility that had an administrator certificate. (Continue on LIC9099C...)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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 5
Control Number 15-AS-20250113081445
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: G.L.O.M. ARF
FACILITY NUMBER: 019200678
VISIT DATE: 04/30/2025
NARRATIVE
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Staff does not ensure facility has a working telephone system
LPA observed facility telephone was in operating condition during visit.

Licensee does not ensure facility maintains financial stability
LPA observed facility has one week of non-perishable and two day perishable food supplies available. Interview with clients and staff revealed the facility had running water and electricity available at the facility.

Staff does not ensure first aide supplies are properly maintained
LPA observed facility has first aid kit supplies available and thermometer was in operating condition during visit.

Staff does not ensure client records are properly maintained
LPA observed facility has client records available at the facility or digitally on their computers. LPA was able to review client records during visit. Interview with clients revealed that client's temperatures are checked daily by staff.

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

Exit interview conducted with Latanya Austin. A copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5