317005902-12-20-2023-59-AS-MSEY-CYQU5C-20231221141632

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005902
Report Date: 12/20/2023
Date Signed: 12/20/2023 09:45:19 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/20/2023 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20231120142441

FACILITY NAME:	CORNERSTONE CRISIS RESIDENTIAL		FACILITY NUMBER:	317005902
ADMINISTRATOR:	DAVIS, HEATHER		FACILITY TYPE:	772
ADDRESS:	101 CIRBY HILLS DRIVE		TELEPHONE:	(916) 788-8144
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	14	CENSUS: 6	DATE:	12/20/2023
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Daniel Klinsmann		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff are sleeping on the job resulting in residents' needs not being met.
Staff did not ensure that resident did not have access to a hazardous object.
Staff member yells in the presence of residents.

INVESTIGATION FINDINGS:

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On 12/20/23, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Associate Director.

LPA conducted records review and interviews.
LPA is unable to find and or meet the preponderance, per policy.

Staff are sleeping on the job resulting in residents' needs not being met- Records and interviews found that the licensee has one awake and one sleepover- on call staff on overnight shifts. While a staff may have been observed to have been sleeping, there was not evidence that residents’ needs were not met by the other staff on duty. The resident, R2, who allegedly made allegations to staff that staff sleep on shift is no longer a resident and is unavailable for interview.

Report continued...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

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

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20231120142441

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CORNERSTONE CRISIS RESIDENTIAL	FACILITY NUMBER: 317005902
	VISIT DATE: 12/20/2023

NARRATIVE

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Staff did not ensure that residents did not have access to a hazardous object- Interviews with facility staff did find that R2 did turn in a utility-knife- like blade to staff. R2 is no longer a resident at the facility and unavailable for interview. Staff statements were that R2 gave a blade to staff after he reportedly found it on top of his room’s armoire style closet.
Staff disposed of the blade and did not further attempt to verify R’2 report of where it was allegedly found.
The blade found is not part of tools or equipment at the facility. Given that it is unknown how the blade came to the facility or how long it was present before discovery, it is unclear if the access was preventable. In discussion with the Director, the Director agreed to enhance the room cleaning procedures between clients to more thoroughly monitor rooms for possible contraband or hazards left by previous occupants.

Staff member yells in the presence of residents- In interviews conducted with staff members, no corroborating witnesses were identified regarding staff members berating each other in clients’ presence. Additionally, given the short term stays of clients at the facility, clients were not able to provide statements for the period of time when the actions are alleged. Therefore it is unsubstantiated that staff behaviors occurred or, if they did, whether they negatively affected clients.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint 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 completed. Report copy provided.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023

LIC9099 (FAS) - (06/04)

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