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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201115
Report Date: 03/08/2024
Date Signed: 03/08/2024 10:58:40 AM

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
03/01/2024 and conducted by Evaluator Laura Hall
COMPLAINT CONTROL NUMBER: 15-AS-20240301083831
FACILITY NAME:JRCE RESIDENTIAL HOME, CORP.FACILITY NUMBER:
079201115
ADMINISTRATOR:CHU, ELVIE RFACILITY TYPE:
735
ADDRESS:3212 VIEW DRIVETELEPHONE:
(925) 238-0044
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:6CENSUS: 3DATE:
03/08/2024
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Joy Chu, LicenseeTIME COMPLETED:
11:05 AM
ALLEGATION(S):
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Staff inappropriately handled a resident.
INVESTIGATION FINDINGS:
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On 3/8/2024 at 9:25am, Licensing Program Analysts (LPAs), L. Hall and T. Syess-Gibson arrived unannounced to conduct the 10-day initial visit and deliver complaint findings for the allegation above. LPA met with Joy Chu, Licensee and explained the reason for the visit.

During the course of the investigation LPAs interviewed two (2) clients, staff, obtained and reviewed client roster, personnel record, Individual Program Plan (IPP) for Client 1 (C1) and Client 2 (C2), and Individual Support Plan for C1.

Reporting Party (RP) stated that the client advised her that a staff member inappropriately handled her. During interview with clients both C1 stated she likes

Continued on LIC9099C.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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-20240301083831
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: JRCE RESIDENTIAL HOME, CORP.
FACILITY NUMBER: 079201115
VISIT DATE: 03/08/2024
NARRATIVE
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Continued from LIC9099.

living at the facility and is treated well. C2 stated she is treated well by all staff, but will be leaving soon. Neither client stated that they have been inappropriately handled or mistreated in any way. S1 stated that C1 has history from her former home stating she was inappropriately handled. S2 stated she has not observed or heard of any mistreatment to the clients.

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 conduct and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2