079200587-1-12-2024-15-AS-KHOS-CZQLHF-20240122074616

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200587
Report Date: 01/12/2024
Date Signed: 01/12/2024 12:59:27 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
10/11/2023 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20231011134723

FACILITY NAME:	LINDA'S RESIDENTIAL CARE II LLC		FACILITY NUMBER:	079200587
ADMINISTRATOR:	PORTILLO, ERLINDA		FACILITY TYPE:	735
ADDRESS:	5220 FEATHER WAY		TELEPHONE:	(925) 565-5106
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY:	6	CENSUS: 6	DATE:	01/12/2024
		UNANNOUNCED	TIME BEGAN:	11:36 AM
MET WITH:	Erlinda Portillo, Administrator		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Clients in care sustained unexplained bruising
Staff hit clients in care
Clients in care are not provided adequate transportation
Clients are left in the facility bathroom for an extended period of time
Clients in care are not provided proper food service
Staff falsify facility documents
Staff mismanaged client funds

INVESTIGATION FINDINGS:

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On 01/12/24 at 11AM, Licensing Program Analyst (LPA) D Panlilio conducted a subsequent visit and met with administrator (ADM) to deliver findings of above allegations. LPA explained the purpose of the visit with ADM.

Allegation: Clients in care sustained unexplained bruising
Finding: Unsubstantiated
During investigation, LPA observed clients (C1, C2, C3, C4, C5, C6) with no visual bruises on their face, arms and legs on unannounced visits dated 09/16/22, 07/19/23, 10/19/23. Clients were observed clean, well-groomed and comfortable with staff and their surroundings. Regional Center of the East Bay Quality Specialist (RCEB QA) also confirmed with LPA that she did not observe any bruises on clients during unannounced quarterly inspections
Continued on next page, LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024

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 4

Control Number 15-AS-20231011134723

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: LINDA'S RESIDENTIAL CARE II LLC	FACILITY NUMBER: 079200587
	VISIT DATE: 01/12/2024

NARRATIVE

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Allegation: Staff hit clients in care
Finding: Unsubstantiated
During investigation, LPA interviewed staff (ADM, S1) who denied hitting, yelling or screaming at any client. Staff stated they continue to assist and redirect clients daily to help them achieve their care plan goals of being independent in performing their daily hygiene needs, being physically and socially active in the community. RCEB QA confirmed with LPA that she did not observe any staff hitting any client during her unannounced quarterly visits. LPA interviewed high functioning verbal client (C3) who stated that she has resided at the facility since 2019 and did not witness staff hit, yell or scream at any client at the facility. LPA observed clients (C1, C2, C3, C4, C5, C6) did not have any visible bruising on their face, arms or legs on unannounced visits dated 09/16/22, 07/19/23, 10/19/23

Allegation: Clients in care are not provided adequate transportation
Finding: Unsubstantiated
During investigation, LPA observed staff (ADM) returning from a client’s doctor’s appointment on 10/19/23. Review of clients' (C1, C2, C3, C4, C5, C6) My Charts' appointment records dated 01/23 thru 10/23 show clients are transported by staff to scheduled doctors' appointments monthly with accompanying test results for documented for each client under My Charts’ electronic records. ADM also stated that staff assist each client with their activities of daily living such as personal hygiene with physical prompting (showering, dressing, grooming, brushing teeth, eating), participating in community activities (outings to the park, restaurants, malls), exercising, taking medications, going to doctors' appointments, doing chores around the home, birthday/holiday event celebrations and managing their personal funds (purchasing clothes, phones, IPads, games, mattress) with purchase receipts and accurate ledger recorded logs.

Continued on next page, LIC 9099-C1

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 15-AS-20231011134723

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: LINDA'S RESIDENTIAL CARE II LLC	FACILITY NUMBER: 079200587
	VISIT DATE: 01/12/2024

NARRATIVE

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Allegation: Clients are left in the facility bathroom for an extended period of time
Finding: Unsubstantiated
During investigation, LPA toured the facility with administrator (ADM) including but not limited to common living room, dining room, kitchen, bathrooms, residents' bedrooms, laundry closet and outside storage shed. LPA did not observe any client locked inside the bathrooms during unannounced visits on 09/16/22, 07/19/23,10/19/23. RCEB QA also confirmed with LPA that she did not observe any client locked inside the bathrooms during her unannounced visits at the facility.

Allegation: Clients in care are not provided proper food service
Finding: Unsubstantiated
During investigation, LPA observed the facility has a minimum of 2-day perishable and 7-day non-perishable food supply including fresh fruits and vegetables, cereals, bread, juice, milk, water, coffee and meats stored in the kitchen refrigerator, freezer, pantry and garage refrigerator/freezer. On 10/19/23 at 12PM, LPA observed clients eating lunch, fresh fruit with water & juice. LPA observed weekly menu showed a variety of meals scheduled from Monday to Sunday. LPA observed that staff provide a variety of food for breakfast, lunch, snacks and dinner with drinks every day. ADM stated clients are provided extra helpings of food and drinks upon request.

Allegation: Staff falsify facility documents
Finding: Unsubstantiated
During investigation, LPA reviewed clients' (C1, C2, C3, C4 C5 & C6) P& I recorded logs which showed that staff maintained a current ledger sheet which showed columns for income, disbursements and balance for each client. Supporting receipts were observed kept in a zippered pouch for reference. LPA observed physical monies matched balance records and were not commingled with facility funds. LPA also reviewed facility's staff roster in Guardian Portal and personnel records (LIC500) dated 10/03/23 which showed all staff are fingerprint cleared and associated with the facility. Continued on next page, LIC-9099C2

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 15-AS-20231011134723

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: LINDA'S RESIDENTIAL CARE II LLC	FACILITY NUMBER: 079200587
	VISIT DATE: 01/12/2024

NARRATIVE

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Allegation: Staff mismanaged clients funds
Finding: Unsubstantiated
During investigation, Administrator (ADM) stated staff do not handle COVID stimulus payments sent to clients' conservators/responsible parties. ADM stated clients’ responsible parties manage their COVID stimulus payments which are monitored by their RCEB case managers. Review of clients' IPP records dated 04/05/22 thru 06/29/23 show each client has an assigned RCEB case manager and court appointed conservator/responsible party in managing their individual service / program plans and financial needs.

Based on records review, interviews conducted, and observations made, the department has investigated the above allegations and found them to be unsubstantiated. A finding that the complaint allegation is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred. Therefore, the above allegations are unsubstantiated.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024

LIC9099 (FAS) - (06/04)

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