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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200877
Report Date: 12/27/2024
Date Signed: 12/27/2024 06:46:49 PM

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
12/20/2024 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20241220160933
FACILITY NAME:NATIONAL PSYCHIATRIC CARE AND REHAB SERVICES INCFACILITY NUMBER:
079200877
ADMINISTRATOR:AQUINO, CARRIE AFACILITY TYPE:
772
ADDRESS:2181 TICE VALLEY BLVDTELEPHONE:
(925) 478-3795
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY:12CENSUS: 7DATE:
12/27/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Program Director Dara StantonTIME COMPLETED:
07:00 PM
ALLEGATION(S):
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Staff yelled at resident.
Staff discriminating against resident.
Staff sleeping while on duty.
INVESTIGATION FINDINGS:
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On 12/26/2024 at 3:00 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this initial 10-day complaint investigation concerning allegations above. LPA met with Program Director (PD) Dara Stanton and informed her of the purpose of the visit.

The complaint alleges staff yelled at resident.
The LPA interviewed the Complainant by phone. At the facility, the LPA reviewed documentation concerning Resident R1. The LPA also interviewed Resident R2 and R3, as well as the PD and Staff Members S1 and S2. Both of the residents, R2 and R3, stated that they had never been yelled at and instead were "very supported". The PD and both staff members denied yelling at Resident R1. They described their interactions with as supportive and their statements as "direct" and not yelling. The data collected does not support the allegation.

Continued on LIC 9099-C . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2024
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 2
Control Number 15-AS-20241220160933
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: NATIONAL PSYCHIATRIC CARE AND REHAB SERVICES INC
FACILITY NUMBER: 079200877
VISIT DATE: 12/27/2024
NARRATIVE
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....Continued from LIC 9099

The complaint alleges that staff discriminated against the resident.
The LPA interviewed the Complainant by phone. At the facility, the LPA reviewed documentation concerning Resident R1. The LPA also interviewed Resident R2 and R3, as well as the PD and Staff Members S1 and S2. Both of the residents, R2 and R3, stated that they had never been discriminated against by any staff member. The PD and both staff members denied that they or any of their colleagues acted in a discriminatory toward Resident R1. The data collected does not support the allegation.

The complaint alleges staff were sleeping while on duty.
The LPA interviewed the Complainant by phone. At the facility, the LPA interviewed Resident R2 and R3, as well as the PD and Staff Members S1 and S2. Both of the residents, R2 and R3, stated that they had never witnessed any staff sleeping on the job and that during the night had regular checks by the staff. The PD stated that there was no evidence that any staff members had slept while on the job. The data collected does not support the allegation

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2