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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019201038
Report Date: 11/29/2022
Date Signed: 11/29/2022 02:59:31 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
09/06/2022 and conducted by Evaluator Gregory Clark
COMPLAINT CONTROL NUMBER: 15-AS-20220906141632
FACILITY NAME:REACHING MILE STONESFACILITY NUMBER:
019201038
ADMINISTRATOR:PORTER, BETTYFACILITY TYPE:
735
ADDRESS:2869 FORD ST # ATELEPHONE:
(510) 463-7483
CITY:OAKLANDSTATE: CAZIP CODE:
94601
CAPACITY:3CENSUS: 2DATE:
11/29/2022
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Latiesha Moses, Care StaffTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Residents needs are not being met due to insufficient staffing
INVESTIGATION FINDINGS:
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On 11/29/22 2:30 p.m. Licensing Program Analyst (LPA) Greg Clark conducted an unannounced visit to deliver the findings for the above allegation. LPA met with Latiesha Moses, Care Staff and explained the purpose of the visit. LPA also spoke with Betty Porter, Administrator via cell phone and received permission for Care Staff to sign the report.

During the course of investigation LPA interviewed the complainant (RP), the Administrator, R1 and R2.

The RP stated that she felt the facility did not have sufficient staff to meet the needs of the residents living there.

The Administrator stated that she was actively hiring additional staff for the facility and planed to bring on 3 new staff in October. ***report continues on LIC9099C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
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 2
Control Number 15-AS-20220906141632
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: REACHING MILE STONES
FACILITY NUMBER: 019201038
VISIT DATE: 11/29/2022
NARRATIVE
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***Report continues from LIC9099***

R1 and R2 both reported being happy living at the facility and had no issues around staff availability to meet their needs. Both reported that facility staff that them to all required appointments.

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, a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2