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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200803
Report Date: 03/06/2025
Date Signed: 03/06/2025 12:38:09 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
06/04/2024 and conducted by Evaluator Laura Hall
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20240604113836
FACILITY NAME:ST FRANCIS HOME IFACILITY NUMBER:
079200803
ADMINISTRATOR:JO, CHRISTOPHERFACILITY TYPE:
735
ADDRESS:1107 METTEN AVETELEPHONE:
(925) 594-2003
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:6CENSUS: 5DATE:
03/06/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Warren Garibay, Direct Care SupportTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff made inappropriate comments towards a resident in care.

Staff are not allowing a resident to attend social events.

Staff are not allowing a resident to make purchases.

Staff are not allowing resident to leave the facility.
INVESTIGATION FINDINGS:
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On 3/6/2025 at 12:00pm, Licensing Program Analyst (LPA), L. Hall arrived unannounced to deliver complaint findings for the allegations above. LPA met with Warren Garibay, Direct Care Support, and explained the reason for the visit.

During the course of the investigation the Department conducted interviews with staff, witness, client, obtained and reviewed records.

Allegation: Staff made in appropriate comments towards a resident in care.

During initial interview W1 stated staff would call C1 fat and tell her that she shouldn’t eat certain foods. During interview with C1 she stated staff says it as a joke that she is

Continued on LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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 3
Control Number 15-AS-20240604113836
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: ST FRANCIS HOME I
FACILITY NUMBER: 079200803
VISIT DATE: 03/06/2025
NARRATIVE
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Continued from LIC9099.

fat when weighed. S3 stated the only thing he said was that her weight was the same as the previous month as he recorded it in our weight log. S4 during interview that no one said anything to C1 ever. LPA reviewed weight chart for C1. The weight charted indicated that C1 had remained the same weight give or take a few ounces from January 2024 to the time C1 moved from facility. W2 stated during interview that there have been instances where C1 could say staff did something but it was later found that the incident did not occur.

Allegation: Staff are not allowing a resident to attend social events.

Based on initial interview W1 stated staff would not transport client to social events. S1 and S2 stated during interview that C1 had attended a fair in Antioch with the day program earlier in the day and wanted to attend the fair when she came home but S2 could not transport C1 being the brakes on the vehicle was in disrepair. C1 stated during interview that S2 said something was wrong with the car and couldn’t take her, but normally S2 will take her where she wants to go.

Allegation: Staff are not allowing a resident to make purchases.

W1 stated during initial interview that when C1 wants to buy things the staff tells C1 she can’t. S1 stated that C1 buys what she wants. If C1 want something bought offline C1 will ask S1 to order it and then give the money for the items. S2 stated C1 buys anything she likes, but there have been times where S2 tried to discourage C1 due to the item is too expensive or unnecessary. S2 stated she’s concerned because C1 doesn’t always return with the right amount of change or receipt which the facility needs for the ledger. C1 stated during interview that there are not any issues with spending her money, she buys what she wants.

Continued on LIC9099C.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20240604113836
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: ST FRANCIS HOME I
FACILITY NUMBER: 079200803
VISIT DATE: 03/06/2025
NARRATIVE
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Continued from LIC9099C.

Allegation: Staff are not allowing resident to leave the facility.

During initial interview W1 stated C1 was not allowed to leave the facility when she wants. C1 stated during interview that she walks to Wal-Mart, takes para transit, the bus, or the staff will take her where she wants to go. S2 stated that C1 comes and goes when she wants. Staff do not stop C1.

Based upon the information obtained and the interviews conducted during investigation, the above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3