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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200070
Report Date: 01/24/2023
Date Signed: 01/24/2023 03:56:51 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
01/20/2023 and conducted by Evaluator Lisha Holmes
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20230120161413
FACILITY NAME:BRIDGE PROGRAM - PLEASANT HILLFACILITY NUMBER:
079200070
ADMINISTRATOR:TRAVIS CURRANFACILITY TYPE:
735
ADDRESS:550 PATTERSON BLVD.TELEPHONE:
(925) 938-8050
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:64CENSUS: 64DATE:
01/24/2023
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Nicole Paiste, Campus AdministratorTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Licensee illegally evicted resident
INVESTIGATION FINDINGS:
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On 01/27/23 at 01:20 PM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct an initial 10-day complaint visit for the above allegation. LPA met with Nicole Paiste, Campus Administrator and explained the purpose of the visit.

During the visit, LPA interviewed Staff #1 (S1), Witnesses (W1, W2) and requested the following documents: Staff and Resident Rosters from 09/2022 to 01/2023, C1's Admission Agreement, Phyicisan's report, Progress Notes, House Rules and related Emails.

continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
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-20230120161413
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: BRIDGE PROGRAM - PLEASANT HILL
FACILITY NUMBER: 079200070
VISIT DATE: 01/24/2023
NARRATIVE
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...continued from LIC9099

Allegation: Licensee illegally evicted resident refers to C1.

C1 was admitted the the facility on 02/24/20 and was placed by Contra Costa County's Conservatorship/Guardianship Program after being released from a locked facility. C1 was no longer conserved and managed by W1 and W2. Progress notes dated 10/03/22 - 10/06/22 documented C1's conversations regarding C1, "No longer wanted to be in the facility". S1, S2, S3, S4, S5, S6, S7 and W1 were present for the conversations. W1 stated that C1's desire to leave wasn't under the best conditions but C1 wanted to go. S1 and W1 told C1 that he/she could return to a facility, but there would be a waitlist if he/she decided to follow through with the discharge. C1 did not want to take his/her personal belongings, but S1 convinced C1 to take a backback with a change of under garments, toiletry items and the trust fund balance.


Based on LPA's interviews and record reviews, 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 Nicole Piaste, Campus Administrator
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2