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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200032
Report Date: 12/20/2024
Date Signed: 12/20/2024 10:47:46 AM

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
11/27/2024 and conducted by Evaluator Laura Hall
COMPLAINT CONTROL NUMBER: 15-AS-20241127084843
FACILITY NAME:FRANKLIN HOME CAREFACILITY NUMBER:
079200032
ADMINISTRATOR:MICHAEL CARIASOFACILITY TYPE:
735
ADDRESS:4307 NULL DRIVETELEPHONE:
(925) 706-9489
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:6CENSUS: 4DATE:
12/20/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Michael Cariaso, AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Facility staff did not ensure that residents grooming needs were met
INVESTIGATION FINDINGS:
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On 12/20/2024 at 10:15am, Licensing Program Analyst (LPA), L. Hall arrived unannounced to deliver complaint findings for the allegation above. LPA met with Administrator, Michael Cariaso, arrived at 10:30am, and LPA explained the purpose of the visit.

During the course of the investigation the Department conducted interviews with staff, witness, and obtained and reviewed records.

Allegation: Facility staff did not ensure that residents grooming needs were met.

Based on email received from W1 there was a conversation held with S1 regarding the grooming needs for C1. Based on interview with W2 C1 asked her to cut his toenails.

Continued on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
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-20241127084843
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: FRANKLIN HOME CARE
FACILITY NUMBER: 079200032
VISIT DATE: 12/20/2024
NARRATIVE
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Continued from LIC9099.

W2 stated the incident was discussed with facility staff and staff explained C1’s personal rights and something about a podiatrist. S1 stated during interview C1 normally refuses to get his toenails cut; however, when C1 agrees he only wants a specific person to cut them. S1 stated a conversation was held with W1 and a resolution was agreed upon to get a referral for a podiatrist and include C1’s responsible party. Based on interviews and record review all parties involved had resolution prior to complaint.

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.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2