079200778-9-1-2022-15-AS-KHOS-CJ2LMY-20220907085331

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200778
Report Date: 09/01/2022
Date Signed: 09/01/2022 12:35:28 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
03/09/2022 and conducted by Evaluator Catherine Lin

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20220309122030

FACILITY NAME:	SOPHIA'S HOME		FACILITY NUMBER:	079200778
ADMINISTRATOR:	HAYAG, LORNA		FACILITY TYPE:	735
ADDRESS:	5243 CONCORD BLVD		TELEPHONE:	(925) 683-1818
CITY:	CONCORD	STATE: CA	ZIP CODE:	94521
CAPACITY:	6	CENSUS: 5	DATE:	09/01/2022
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Lorna Hayag, Administrator		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Resident is being sexually harassed by another resident
Planned activities are not provided

INVESTIGATION FINDINGS:

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On 9/1/2022 at 10:45 a.m., Licensing Program Analysts (LPAs) C. Lin and L. Alexander conducted an unannounced subsequent complaint investigation regarding the above allegations and respect to deliver investigation findings. LPAs explained the purpose of the visit with administrator.

Allegation: Resident is being sexually harassed by another resident – Unsubstantiated.
The Department has investigated this allegation and per records review and interviews, and found that when R1 felt being bothered by R4’s behavior, staff had taken actions of keeping them in distance, educating and monitoring R4, discussing with R4’s primary physician and family member who involved to help R4 to understand what would or would not be appropriate to do. R1 stated that R4 took a long time to understand, and now R4 didn’t bother R1 anymore. R1 stated that staff has been always helpful when R1 asked for assistance.

Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Catherine Lin
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

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-20220309122030

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: SOPHIA'S HOME	FACILITY NUMBER: 079200778
	VISIT DATE: 09/01/2022

NARRATIVE

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Allegation - Planned activities are not provided – Unsubstantiated
The Department has investigated this allegation and per records review and interviews, and found that staff did provide activities to clients including but not limited to buying burgers, shopping, walking in the backyard or around the house, and exercising in the backyard. Clients and staff stated that outdoor activities were provided but limited during the time of Covid-19 pandemic.

Based on observation, records reviewed, and interview conducted, the above allegations are unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

No deficiency cited, exit interview conducted with administrator, and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Catherine Lin
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022

LIC9099 (FAS) - (06/04)

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