075600757-3-8-2024-15-AS-YFLS-D3HNQ4-20240319103918

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 075600757
Report Date: 03/08/2024
Date Signed: 03/08/2024 02:34:45 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
12/15/2023 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20231215094125

FACILITY NAME:	FAMILY COURTYARD		FACILITY NUMBER:	075600757
ADMINISTRATOR:	TEJERO, NORMA		FACILITY TYPE:	740
ADDRESS:	2840 SALESIAN AVENUE		TELEPHONE:	(510) 235-8284
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94804
CAPACITY:	70	CENSUS: 44	DATE:	03/08/2024
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Norma Tejero, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff did not prevent a resident from sexually harassing another resident while in care
Staff did not prevent a resident from threatening another resident while in care
Staff are interfering with a resident's visitations
Staff are intimidating a resident while in care
Staff are not meeting a resident's dietary needs
Staff are not providing comfortable environment for a resident

INVESTIGATION FINDINGS:

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On 3/08/24 at 11:00 a.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to deliver findings in regard to the allegations above. LPA met with Norma Tejero, Administrator, and explained the purpose of the visit.

During the course of the investigation LPA interviewed the reporting party (RP), S1 and R1 and R2. LPA also reviewed R1’s and R2’s facility file. R1 was admitted to the facility on 8/12/22 from Contra Costa Regional Medical Center’s psychiatric Unit. R1 has a history of aggressive and threatening behavior resulting in 5150 psychiatric hospitalizations. R1 is currently stable at this facility.

R2 was admitted to the facility on 12/18/15 from independent living. R2 is diagnosed with schizoaffective disorder and has a long history of psychiatric hospitalizations. R2 was stable at this facility until recently when he got upset and hit a staff. R2 was 5150’d and returned to the facility with an agreement to take all his medications as prescribed. R2 is currently stable.
***report continues on LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory Clark	TELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

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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Control Number 15-AS-20231215094125

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: FAMILY COURTYARD	FACILITY NUMBER: 075600757
	VISIT DATE: 03/08/2024

NARRATIVE

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***report continues from LIC9099***

Investigation regarding the allegations follows.

Staff did not prevent a resident from sexually harassing another resident while in care:

R1 denied being sexual harassed by R2 and R2 denied sexually harassing R1. R1 further stated that she hardly sees R2 anymore. R2 told LPA that his roommate is a female, stating "they trust me" and it's nothing sexual adding "sex isn't allowed."

Staff did not prevent a resident from threatening another resident while in care:

R1 stated that she was never threatened by any of the residents at the facility and that she enjoys living here and has made several friends.

Staff are interfering with a resident's visitations:

House rules state all visitors must check in at the reception desk in the front lobby. Facility staff will then go get the person they want to visit and bring them to the lobby for the visit. Residents are free to take visitors back to their room is the resident’s roommate agrees (all rooms are shared rooms).

Staff are intimidating a resident while in care:

R1 denied being intimidated by staff stating the staff here are “nice” and “helpful” when she asks for things.

Staff are not meeting a resident's dietary needs:

R1’s physicians report dated 8/18/22 indicated that R1 is on a regular diet.

Staff are not providing comfortable environment for a resident:

During LPA’s first visit to the facility (12/21/23) R1 was observed sleeping in her bed under several blankets. R1 stated that is comfortable at the facility and has enough clothing and blankets to keep her warm.

This agency has investigated this complaint. We have found that the complaint was unsubstantiated. 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.

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Gregory Clark	TELEPHONE: 510-285-3927
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

LIC9099 (FAS) - (06/04)

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