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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200952
Report Date: 09/16/2022
Date Signed: 09/16/2022 04:02:00 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
11/03/2021 and conducted by Evaluator Daisy Panlilio
COMPLAINT CONTROL NUMBER: 15-AS-20211103093820
FACILITY NAME:LINDA'S RESIDENTIAL CARE IIIFACILITY NUMBER:
079200952
ADMINISTRATOR:PORTILLO, ERLINDAFACILITY TYPE:
735
ADDRESS:5145 TURNBULL CTTELEPHONE:
(925) 565-5106
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY:6CENSUS: 6DATE:
09/16/2022
UNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Luis Fernandez, AdministratorTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff left resident in soiled clothing for extended period of time
Staff yells at resident
Staff has residents walk in uncomfortable weather
Staff did not ensure resident is provided with water
INVESTIGATION FINDINGS:
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On 09/16/22 at 3:30PM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced subsequent visit and met with administrator to deliver the finding of above allegations. LPA explained the purpose of the visit with administrator.

Allegation: Staff left resident in soiled clothing for extended period of time
Investigation Finding: Unsubstantiated
Based on interviews and record reviews, client (C1) is high functioning, ambulatory and able to communicate her needs to staff. C1 told LPA that staff assist her whenever she needs help and have no concerns with staff. Other clients (C2 and C3) interviewed confirmed that staff is always there to assist them with their daily needs. Staff stated that they assist clients in using the bathroom at night and change their diapers as needed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.
Continued on next page, LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022
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-20211103093820
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: LINDA'S RESIDENTIAL CARE III
FACILITY NUMBER: 079200952
VISIT DATE: 09/16/2022
NARRATIVE
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Allegation: Staff yells at resident
Investigation Finding: Unsubstantiated
During investigation, client (C1) stated she does not recall staff yelling or screaming at her. Other clients (C2, C3) stated that staff does not yell or scream at them. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.

Allegation: Staff has residents walk in uncomfortable weather


Investigation Finding: Unsubstantiated
Based on interviews and record reviews, staff stated they take clients on occasional walks to the nearby park. Clients (C2, C3) confirmed with LPA that they bring their own personal water containers whenever they walk to the park. Staff stated they ensure all clients are hydrated and discourages them from going out if the weather is extremely hot. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.

Allegation: Staff did not ensure resident is provided with water


Investigation Finding: Unsubstantiated
During investigation, clients (C2, C3) showed LPA their personal water bottles that they take with them whenever they go to the local park or other outings. Staff stated clients typically bring their own water containers with their names on them. Staff stated they also bring extra water bottles, cold drinks and snacks in a cooler whenever they drive clients to the local park. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.

No deficiencies cited. Exit Interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Daisy Panlilio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2