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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157208893
Report Date: 10/17/2023
Date Signed: 10/17/2023 05:08:50 PM

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
07/03/2023 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20230703143914
FACILITY NAME:SAILS VIIFACILITY NUMBER:
157208893
ADMINISTRATOR:MARQUEZ, JOSEFACILITY TYPE:
735
ADDRESS:4013 REDFORD CTTELEPHONE:
(661) 473-2339
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:4CENSUS: 4DATE:
10/17/2023
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Administrator Jose MarquezTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff hit resident
Staff handled resident in a rough manner
Staff makes inappropriate comments towards residents
Staff is not effectively communicating with resident
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Shawna Doucette contacted the facility to commence a complaint investigation. LPA identified herself and explained the purpose of the visit and the elements of the allegations with Administrator Jose Marquez. LPA delivered findings.

LPA interviewed staff and clients. LPA requested copies of staff files which will be provided via email.

Based on interviews and photos, it was found Staff hit resident and Staff handled resident in a rough manner. LPA recieved photos showing a physical encounter with C1 by S1. After conducting interviews it was found staff was physical with C1.

Based on interviews and audio video it was found, Staff makes inappropriate comments towards residents and Staff is not effectively communicating with resident. LPA recieved audio video of staff speaking



Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
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 5
Control Number 24-AS-20230703143914
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 VII
FACILITY NUMBER: 157208893
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/18/2023
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights (a) ....., each client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Plan of Correction POC Licensee agrees to conduct staff training for all staff on abuse. Licensee agrees to submit completed training by POC due date by 09/27/23.
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This requirement was not met as evidenced by: Licensee did not ensure C1 was free from corporal or unusual punishment by interviews and photos of S1 holding C1 down with S1's knee in C1's upper back/neck and arm twisted behind C1's back on the floor which poses an immediate health safety and/or personal rights risk to clients in care.
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Type A
10/18/2023
Section Cited
CCR
80072(a)(1)
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80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
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Plan of Correction POC Licensee agrees to conduct staff training on personal rights. Licensee agrees to submit completed training by POC due date by 09/27/23.
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This requirement was not met as evidenced by Licensee did not ensure C1 was accorded dignity by an audio recording of S1 cursing at C1 in front of other staff which poses and immediate health, safety and or personal rights risk to clients 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: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 24-AS-20230703143914
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 VII
FACILITY NUMBER: 157208893
VISIT DATE: 10/17/2023
NARRATIVE
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inappropriate and not effectively communicating to clients. After conducting interviews it was found staff spoke inappropriately to clients.


Based on the Departments interviews, photos and audio video the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Article 8, is being cited on the attached LIC 9099D.


A copy of this report was provided to Administrator with plans of correction and appeal rights.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
07/03/2023 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20230703143914

FACILITY NAME:SAILS VIIFACILITY NUMBER:
157208893
ADMINISTRATOR:MARQUEZ, JOSEFACILITY TYPE:
735
ADDRESS:4013 REDFORD CTTELEPHONE:
(661) 473-2339
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:4CENSUS: 4DATE:
10/17/2023
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Administrator Jose MarquezTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff are not allowing residents to use their PNI
Staff are not letting residents go on outings
Staff are restricting resident's phone calls
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Shawna Doucette contacted the facility to commence a complaint investigation. LPA identified herself and explained the purpose of the visit and the elements of the allegations with Administrator Jose Marquez.

LPA interviewed staff and clients.

Based on interviews Staff are allowing residents to use their PNI. It is undetermined if there was a specific incident where staff did not allow a resident to use their PNI.

Based on interviews, Staff are allowing residents to go on outings. It is undetermined if there was a specific incident where staff did not allow residents to go on outings.

Based on interviews staff are not restricting residents phone calls. It is undetermined if there was a specific
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 24-AS-20230703143914
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 VII
FACILITY NUMBER: 157208893
VISIT DATE: 10/17/2023
NARRATIVE
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incident where staff did not allow residents to use the phone.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.


A copy of this report was provided to Administrator.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5