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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079201349
Report Date: 05/20/2025
Date Signed: 05/20/2025 02:04:21 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
03/11/2025 and conducted by Evaluator Lisha Holmes
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250311160746
FACILITY NAME:CATALYST CARES ADULT DAY PROGRAMFACILITY NUMBER:
079201349
ADMINISTRATOR:FREEMAN, MAVISFACILITY TYPE:
775
ADDRESS:3905 SAN PABLO DAM ROADTELEPHONE:
(510) 390-5538
CITY:EL SOBRANTESTATE: CAZIP CODE:
94803
CAPACITY:60CENSUS: 30DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Mavis Freeman, CEO/Administrator TIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff hit client resulting in injury
INVESTIGATION FINDINGS:
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On 05/20/2025 around 12:10 PM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to deliver the finding for the complaint investigation. LPA met with Mavis Freeman, CEO/Administrator and explained the purpose of the visit.

During the course of the investigation and visits, LPA conducted interviews and obtained statements from Staff (S1, S2, S3, S4), Witnesses (W1, W2) and Client #2 (C2). LPA and S1 toured the facility, LPA requested a staff and resident roster including but not limited to Client #1 (C1) attendance records, face sheet, self-injurious reports, training records, behavior plans, behavior response policy, admission agreement, LIC 624s, progress and assessment reports.

Continued on LIC9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 2
Control Number 15-AS-20250311160746
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: CATALYST CARES ADULT DAY PROGRAM
FACILITY NUMBER: 079201349
VISIT DATE: 05/20/2025
NARRATIVE
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...continued from LIC9099.

Allegation: UNSUBSTANTIATED
Staff hit client resulting in injury

On 02/20/2025, the alleged allegation occurred at R1’s Day Program. W2 reported what was relayed to him/her from W1 to the Contra Costa County Sheriff's Department, and law enforcement was dispatched on 02/27/2025. ADM provided LPA with proof of communications regarding R1 that included text messages, emails, attendance records, and LIC 624 which were all related to R1's behavioral history from 2024 to 2025. Interviews and statements from S1, S2, S3, S4, W1, and W2, and the history for the police incident did not reveal that any staff hit R1, or any other Clients. S1 had not received any written or oral communications from W1 or W2 regarding the allegation in order to investigate any wrong doings prior to 02/27/2025.

Based on information obtained, the allegation is UNSUBSTANTIATED. A finding that the complaint is unsubstantiated means that the allegation is not valid because the preponderance of the evidence standard has not been met.

No deficiency cited, exit interview conducted, a copy of this report provided Mavis Freeman, CEO/Administrator.

SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Lisha Holmes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2