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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200616
Report Date: 06/23/2023
Date Signed: 08/03/2023 03:45:03 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
05/26/2023 and conducted by Evaluator Gregory Clark
COMPLAINT CONTROL NUMBER: 15-AS-20230526171354
FACILITY NAME:LUCCHESI GROUP ADULT RESIDENTIAL CAREFACILITY NUMBER:
079200616
ADMINISTRATOR:VALADEZ, ARMANDOFACILITY TYPE:
735
ADDRESS:4739 LUCCHESI COURTTELEPHONE:
(925) 457-0913
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:4CENSUS: 4DATE:
06/23/2023
UNANNOUNCEDTIME BEGAN:
12:44 PM
MET WITH:Rafael Rubio, AdministratorTIME COMPLETED:
01:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit and pushed resident.
Staff does not meet resident's hygiene needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
***This is an amended report***On 8/03/23 at 3:41 p.m., Licensing Program Analyst (LPA) Greg Clark arrived unannounced to deliver findings for the allegations above. LPA met with Rafael Rubio, Administrator and explained the purpose of the visit.

During the investigation LPA interviewed the reporting party, 4 facility staff (S1, S2, S3 and S4) and R1. RP stated that R1 told her that a staff at the facility hit and pushed her. RP further stated that R1 sometimes "exaggerates" her stories. R1 stated that the staff at the facility are "great", and she is happy living there. R1 denied that any of the staff ever hit or pushed her. R1 also stated that she takes care of her personal hygiene needs by herself. All facility staff stated they never heard any of the residents' state that they were hit by facility staff.

Based on interviews conducted this agency has found that the allegations are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted, a copy of this report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
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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