340314399-4-23-2021-27-AS-CACL-C2JUT3-20210429155115

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 340314399
Report Date: 04/23/2021
Date Signed: 04/23/2021 03:52:46 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2021 and conducted by Evaluator Tung Truong

COMPLAINT CONTROL NUMBER: 27-AS-20210222111023

FACILITY NAME:	DOSTY'S PRIVATE INCARE SERVICE		FACILITY NUMBER:	340314399
ADMINISTRATOR:	JANAE ROSS		FACILITY TYPE:	735
ADDRESS:	7093 CROMWELL WAY		TELEPHONE:	(916) 399-1365
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95822
CAPACITY:	6	CENSUS: 4	DATE:	04/23/2021
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Administrator, Janae Ross		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff sexually abused resident's in care.
Staff eats resident's food.
Staff uses resident's personal items.
Staff is under the influence of alcohol and drugs while providing care and supervision to residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tung Truong contacted the facility via telephone to deliver investigation findings on 04/23/2021 due to COVID-19 and pre-cautionary measures. LPA identified himself and discussed the purpose of the call and the elements of the allegations with administrator Janae Ross.

Throughout the course of the investigation, the Department conducted interviews and reviewed facility records. The investigation revealed clients made no disclosures of sexual abuse and reported no inappropriate behavior by staff (S-1) or by any staff. Staff (S-2) and (S-3) reported no inappropriate behavior by S-1 and felt the clients were safe under S-1 supervision. S-1 denied all the allegations of sexual abuse and inappropriate behavior.

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021

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 27-AS-20210222111023

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: DOSTY'S PRIVATE INCARE SERVICE	FACILITY NUMBER: 340314399
	VISIT DATE: 04/23/2021

NARRATIVE

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The investigation revealed the lack of evidence to substantiate that staff eats resident's food and uses resident's personal items. Client (C-2) reported staff did not eat client's food. Client (C-3) reported staff sometime eat the food that the staff cook. The administrator reported there is plenty of food at the facility and there was no restriction that staff can't eat them. Clients have no complaints that staff are eating the food. The administrator reported staff mostly eat their own food that they brought with them.

The investigation revealed the lack of evidence to substantiate that staff uses resident's personal items. Staff (S-3) reported she sometimes play with client (C-4) on his Xbox and only in the presence of the client. Client (C-3) reported staff only uses client's item if they asked. C-3 reported staff respects the clients and provided good care.

This agency has investigated the complaint alleging the above allegations to be 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 was conducted with Administrator. Copy of the report sent to Administrator via e-mail with a "read receipt" to verify the LIC 9099, LIC 9099-C and appeal rights was provided. Administrator is to print out each report, sign it, and send back via email to LPA.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2021

LIC9099 (FAS) - (06/04)

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