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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157206261
Report Date: 07/15/2022
Date Signed: 07/15/2022 10:28:07 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/07/2022 and conducted by Evaluator Mai Yang
COMPLAINT CONTROL NUMBER: 24-AS-20220207085957
FACILITY NAME:SAILS XFACILITY NUMBER:
157206261
ADMINISTRATOR:TUCKER, JACQUELINEFACILITY TYPE:
735
ADDRESS:7617 INDIAN GULCH STTELEPHONE:
(661) 473-2333
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:5CENSUS: 5DATE:
07/15/2022
UNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Administrator Jacqueline “Jacki” TuckerTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff member does not treat client with dignity and respect
Staff member does not respect resident (s) privacy
Posting on social media without residents’ consent
INVESTIGATION FINDINGS:
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On 7/15/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver the findings on the above allegations. LPA met with Administrator Jacqueline “Jacki” Tucker and announced the purpose of the visit.

The Department conducted interviews and reviewed records. Based on records reviewed, it was confirmed that R1 in the social media post resides at the facility. The photo was taken without the resident’s knowledge. The preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. Per Title 22, the following deficiencies are being cited on the attached 9099D. Plan of correction was discussed. Appeal rights given. Exit interview completed.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2022
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 24-AS-20220207085957
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: SAILS X
FACILITY NUMBER: 157206261
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2022
Section Cited
CCR
80072(a)(1)
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Except for children’s residential facilities, each client shall have personal rights which include…To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement was not met:

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Administrator agrees to submit a plan by POC due date of when staff will be trained on Personal Rights. Training will include date, signature of facility staff who attended, and topics.
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Based on records reviewed, staff posted to social media Snapchat a picture of R1 with insults, which poses an potential health and safety risks to the residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2