079200616-9-18-2023-15-AS-BFOG-CWSMN9-20231020094508

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200616
Report Date: 09/18/2023
Date Signed: 09/18/2023 11:13:23 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 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
03/02/2023 and conducted by Evaluator James Sampair

COMPLAINT CONTROL NUMBER: 15-AS-20230302095308

FACILITY NAME:	LUCCHESI GROUP ADULT RESIDENTIAL CARE		FACILITY NUMBER:	079200616
ADMINISTRATOR:	VALADEZ, ARMANDO		FACILITY TYPE:	735
ADDRESS:	4739 LUCCHESI COURT		TELEPHONE:	(925) 457-0913
CITY:	OAKLEY	STATE: CA	ZIP CODE:	94561
CAPACITY:	4	CENSUS: 4	DATE:	09/18/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Armando and Maria Valadez		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff caused injuries to a client while in care

INVESTIGATION FINDINGS:

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On 09/18/2023 at 10:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to deliver findings on the above allegation. LPA met with Licensees Armando Valadez and Maria Valadez.

Over the course of this investigation, the Department has reviewed facility, medical, and collateral agency records, and interviews of current staff, witnesses, and facility clients. According to the Department’s review of Oakley Police Reports, facility notes, and statements from the Complainant, Client 1 (C1)’s case workers (Witnesses W1, W2, W3, and W5), other facility clients (Clients C3 and C4), and caregivers (Staff S1, S2, S3, S4, S5, and S6), C1 has a history of behaviors that include self-injury, violence towards others, and false allegations. Those false allegations from C1 include accusing caregivers of inappropriately touching or hurting her. During the timeframe when the Complainant had observed injuries on C1, there exists extensive documentation showing that C1, and not caregivers, had caused her injuries.

(Continued on LIC9099-C1...)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

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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Control Number 15-AS-20230302095308

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: LUCCHESI GROUP ADULT RESIDENTIAL CARE	FACILITY NUMBER: 079200616
	VISIT DATE: 09/18/2023

NARRATIVE

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(...Continued from LIC9099)

The Department interviewed C1’s housemates, C3 on 04/25/2023 and C4 on 05/09/2023. C3 stated that C1 hits staff, throws shoes at them, takes her clothes off, runs out the front and back doors, and refuses to go to day program. Caregivers don't do anything to C1, they just tell her to calm down and follow her when she leaves. C3 stated, "I like the house I live in and feel comfortable." C4 stated that C1 hits caregivers, growls at him and argues with C3. She picks at her scabs and makes holes in the walls with her hands. She yells, throws things, makes threatening statements, and tells caregivers and C3 that she wants to kill them. In response, caregivers try to calm her down and keep their distance from C1 when she acts violently. C4 described former caregivers S2 and S3 as "cool" and that they were patient with and tried to accommodate C1. C4 stated that he had never seen anyone mistreat or hit C1. On four occasions between 03/23/2023 and 05/09/2023, the Department attempted interviews of C1, but each time C1 refused to speak.

The Department interviewed a total of 5 witnesses, W1 and W2 on 03/23/2023, W3 and W5 on 04/14/2023, and W8 on 04/25/2023. C1 has been W1’s client at the day program for 5 years. W5 stated that C1 is resistive when she does not get her way, and has a history of going AWOL, making false allegations against staff and peers and physical aggression. C1 is very particular about which staff at day program she wants working with her. If C1 does not like a particular staff, she will make false allegations against them. C1 had not complained about caregivers in the home, nor had she reported being physically abused since she moved into the facility. W2 stated that her client, C2, lives at the facility and that he seems happy and that she had no concerns to report. W5’s client, C3, likes living in the facility, where she has lived since December 2022. C3 has not sustained injuries since she moved in. W5 said that the facility is good, and the administrator is informative. W8 is C3’s day program teacher's aide. She said that C3 speaks highly of her caregivers but has reported having issues with C1.

(Continued on LIC9099-C2...)

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

LIC9099 (FAS) - (06/04)

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Control Number 15-AS-20230302095308

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: LUCCHESI GROUP ADULT RESIDENTIAL CARE	FACILITY NUMBER: 079200616
	VISIT DATE: 09/18/2023

NARRATIVE

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(... Continued from LIC9099-C1)

On 03/23/2023, the Department reviewed notes from the facility concerning C1. On 01/01/2023, C1 had banged herself against the walls. On 01/03/2023, C1 had thrown herself on the floor. On 01/05/2023, C1 was aggressive towards caregivers, threw things at them, and called the police to report that a caregiver was touching her. Police responded and interviewed C1. No further action was made by the police. On 01/06/2023, C1 was upset and aggressive, scratched herself vigorously, banged her hands against the wall, and used her weight to push onto a closed door. On 01/11/2023, C1 injured her knee while attempting to leave the facility without permission (AWOL). During the attempted AWOL, C1 spit and threw things at caregivers. On 01/23/2023, when C1 returned from day program, she had bruises on her face above her left eye. On 01/29/2023, S5 told Complainant that while giving C1 a bath she noticed a bruise on the left of C1's left breast.

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 via email.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

LIC9099 (FAS) - (06/04)

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