317003807-9-26-2022-25-AS-LMUZ-CJPRHS-20220928130248

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317003807
Report Date: 09/26/2022
Date Signed: 09/26/2022 11:36:43 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, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/02/2022 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 25-AS-20220802110810

FACILITY NAME:	BADETTE'S PLACE INC.		FACILITY NUMBER:	317003807
ADMINISTRATOR:	CARRILLO, BLES		FACILITY TYPE:	735
ADDRESS:	9455 DUFFY LANE		TELEPHONE:	(916) 773-1925
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	4	CENSUS: 4	DATE:	09/26/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Administrator-Bles Carrillo		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Licensee is providing false statements.

INVESTIGATION FINDINGS:

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On 09/26/22, Licensing Program Analyst (LPA) Talwinder Bains conducted an unannounced complaint investigation visit and deliver the findings for the above allegations and met with Administrator-Bles Carrillo. Prior to initiating the complaint visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Upon arrival, completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened with temperature at the facility.

The department conducted records review, facility observation and extensive interviews for this complaint investigation.

**Report continued on LIC9099-C**

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

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 6

Control Number 25-AS-20220802110810

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: BADETTE'S PLACE INC.	FACILITY NUMBER: 317003807
	VISIT DATE: 09/26/2022

NARRATIVE

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** Report continued from 9099:

Allegation--Licensee is providing false statements - Substantiated:

The Department conducted interviews and reviewed records to investigate this allegation. Based on 3 staff interviews and facility record review of facility staffing schedules, the Department has concluded that the licensees falsified staffing schedules regarding staff work schedule and staff’s actual hours worked. In addition, the licensees provided false information to CCL and other government regulatory agencies in regard to staffing hours and schedules Based on staff interviews, the department found substantiated evidence to conclude that the administrators were imply promises of financial benefits to staff if they provide false information during interviews, therefore this allegation is Substantiated. Based on interviews, facility observations and records review conducted by the department, the preponderance of evidence standards has been met. Therefore, the above allegation is found to be SUBSTANTIATED.

No citation will be issued for this violation as the facility was cited on 09/26/22 for the same violation.
Exit interview was conducted with Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/02/2022 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 25-AS-20220802110810

FACILITY NAME:	BADETTE'S PLACE INC.		FACILITY NUMBER:	317003807
ADMINISTRATOR:	CARRILLO, BLES		FACILITY TYPE:	735
ADDRESS:	9455 DUFFY LANE		TELEPHONE:	(916) 773-1925
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	4	CENSUS: 4	DATE:	09/26/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Administrator-Bles Carrillo		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Licensees are intimidating staff to speaking with CCL and other government agencies.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 5 of 6

Control Number 25-AS-20220802110810

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: BADETTE'S PLACE INC.	FACILITY NUMBER: 317003807
	VISIT DATE: 09/26/2022

NARRATIVE

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** Report continued from 9099-A:

Licensees are intimidating staff to speaking with CCL and other government agencies - Unsubstantiated:

The Department conducted interviews and reviewed facility records to investigate this allegation. Department has conducted interviews with facility residents, staff, and administrators (A1 and A2) regarding this allegation. All individuals interviewed denied this allegation of licensees are intimidating staff to speaking with CCL and other government agencies of facility staff however, licensee did ask staff to provide false information in regard to staffing schedules and hours. Based on department’s investigation as stated above, the preponderance of evidence standards has not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview was conducted with Administrator and a copy of this report was provided to the facility.
The signature of the Administrator on these forms acknowledges receipt of these documents.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

LIC9099 (FAS) - (06/04)

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