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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700065
Report Date: 12/01/2023
Date Signed: 12/01/2023 04:33:10 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
08/14/2023 and conducted by Evaluator Maja Jensen
COMPLAINT CONTROL NUMBER: 27-AS-20230814164513
FACILITY NAME:WILTON STABLESFACILITY NUMBER:
342700065
ADMINISTRATOR:TANYA BARRETOFACILITY TYPE:
735
ADDRESS:11119 MANN ROADTELEPHONE:
(916) 687-4548
CITY:WILTONSTATE: CAZIP CODE:
95693
CAPACITY:4CENSUS: 4DATE:
12/01/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kolu SokodoloTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff force residents to do house chores
Conduct Inimical
Facility staff take client items away as a form of punishment
Facility staff do not allow residents to use their cell phone
Facility did not have sufficient staff on weekends
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/1/23 Licensing Program Analyst (LPA) Maja Jensen arrived at facility announced to continue a complaint investigation in to the above listed allegations. LPA Jensen met with Administrator Kolu Sokdolo and explained the purpose of today's visit.

During the course of this investigation LPA's Maja Jensen and Christina Valerio interviewed the facility Regional Manager, the former Administrator, 4 current staff members, 1 former staff member, a service coordinator and a current resident. LPA Jensen also reviewed a report given by a resident family member and a copy of the program rules and regulations.

Facility staff force residents to do chores
2 of 4 current staff members stated during an interview that resident 1 (R1) was forced to do chores. 2 of 2 staff members indicated that they did not personally witness residents being forced to do chores but heard about it and believed it to be true.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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 8
Control Number 27-AS-20230814164513
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: WILTON STABLES
FACILITY NUMBER: 342700065
VISIT DATE: 12/01/2023
NARRATIVE
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1 former staff member stated they worked the NOC shift and as such would not have witnessed this type of occurrence. No one other than the former Administrator denied these allegations. Based on interviews conducted the allegation of facility staff force residents to do house chores is SUBSTANTIATED. A finding of substantiated means that the preponderance of evidence standard has been met.

Conduct Inimical
3 current staff members, a resident, a resident's family member all confirmed that they have witnessed the former Administrator yelling at residents. The service coordinator interviewed stated that the former Administrator spoke to them unprofessionally and used profanity when engaging with them. Staff members and a resident also stated in interviews that they witnessed the Administrator use coercion and/or made threats to residents by stating they use will take the residents personal funds to pay for property damage. Based on interviews conducted the allegation of Conduct Inimical is SUBSTANTIATED. A finding of substantiated means that the preponderance of evidence standard has been met.

Facility staff take client items away as a form of punishment
2 staff members interviewed and a resident stated that items had been taken away as a form of punishment. No one interviewed other than the former Administrator denied this could have occurred. Based on interviews conducted the allegation of facility staff take client items away as a form of punishment is SUBSTANTIATED. A finding of substantiated means that the preponderance of evidence standard has been met.

Facility staff do not allow residents to use their cell phone
1 staff member interviewed stated that they had witnessed an occasion where a resident was not allowed to use their cell phone. The former Administrator stated that residents were always allowed to use their cell phone and always had funds to pay their cell phone bills however facility staff had 2 residents for which they purchased cards in order for the residents to use their cell phone and staff was not always able to obtain the cards. Based on the interviews conducted the allegation of facility staff do not allow residents to use their cell phone is SUBSTANTIATED. A finding of substantiated means that the preponderance of evidence standard has been met.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 27-AS-20230814164513
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: WILTON STABLES
FACILITY NUMBER: 342700065
VISIT DATE: 12/01/2023
NARRATIVE
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Facility did not have sufficient staff on weekends
During the course of an interview, the former Administrator stated that if all clients went home for the weekend then staff would not be at the facility but she personally would be on call. She further stated that there had been 2 occasions wherein resident family members had called her requesting the resident be able to return to the facility early however she was unable to pick up the clients until the following day because she was busy. Staff and family members and a Regional Center Service Coordinator also confirm this occurred. Based on interviews conducted the allegation of facility did not have sufficient staff on weekends is SUBSTANTIATED. A finding of substantiated means that the preponderance of evidence standard has been met.

It should be noted that the former Administrator is no longer employed at this facility. The Licensee has appointed a new Administrator and a Regional Manager to provide oversight of the Administrator and facility. The new Administrator and Regional Manager have conducted an evaluation of facility policies and procedures and implemented changes to promote the well being of clients in care. Alta Regional Center has also conducted a site visit and implemented plans of correction which have been completed as of 11/30/23.

Deficiencies are being cited pursuant to the California Code of Regulations (CCR). Failure to correct deficiencies may result in the assessment of civil penalties. The Department also reserves the right to review the violations for potential Administrative action.

An exit interview was conducted and a copy of this report, LIC 811 and appeal rights were provided.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 27-AS-20230814164513
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: WILTON STABLES
FACILITY NUMBER: 342700065
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/08/2023
Section Cited
CCR
80072(a)(1)
1
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7
Personal Rights
...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 based on:
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7
The Administrator or Licensee agrees to send an attestation that this regulation has been read, understood and will be complied with and will send a plan detailing the changes the facility has made or will make to prevent a reoccurrence.
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LPA's interviews wherein it was stated that a resident or residents were forced to chores. This poses a potential risk to the health, safety and personal rights of residents in care.
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Type B
12/08/2023
Section Cited
CCR
85072(b)(6)
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7
Personal Rights
The licensee shall insure that each client is accorded the following personal rights.
...To possess and use his/her own personal items...This requirement was not met based on:
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The Administrator or Licensee agrees to send an attestation that this regulation has been read, understood and will be complied with and will send a plan detailing the changes the facility has made or will make to prevent a reoccurrence.
8
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LPA's interviews wherein it was stated that facility staff would take away resident's personal belongings as a form of punishment. This poses a potential risk to the health, safety and personal rights of residents in care.
8
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14
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: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 8
Control Number 27-AS-20230814164513
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: WILTON STABLES
FACILITY NUMBER: 342700065
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/08/2023
Section Cited
CCR
85072(b)(3)
1
2
3
4
5
6
7
Personal Rights
The licensee shall insure that each client is accorded the following personal rights...To have communications to the facility from his/her relatives or authorized representative answered promptly and completely.
1
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The Administrator or Licensee agrees to send an attestation that this regulation has been read, understood and will be complied with and will send a plan detailing the changes the facility has made or will make to prevent a reoccurrence.
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This requirement was not met based on LPAs interviews wherein it was stated that there were occasions when residents were unable to use their cell phone which impedes the ability to communicate promptly. This poses a potential risk to the health, safety and personal rights of 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: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 8
Control Number 27-AS-20230814164513
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: WILTON STABLES
FACILITY NUMBER: 342700065
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/08/2023
Section Cited
CCR
80064(a)(3)
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2
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7
Administrator Qualifications and Duties
Knowledge of and ability to comply with applicable law and regulation. This requirement was not met as evidenced by:
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The Administrator or Licensee agrees to send an attestation that this regulation has been read, understood and will be complied with and will send a plan detailing the changes the facility has made or will make to prevent a reoccurrence.
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Based on LPAs interviews the Administrator engaged in various personal rights violations including but not limited to not ensuring sufficeint staffing and not ensuring residents are treated with dignity and respect. This poses an immediate risk to the health, safety and personal rights of residents in care.
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Type A
12/08/2023
Section Cited
CCR
85065(b)
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7
Personnel Requirements
The licensee shall employ staff as necessary to ensure provision of care and supervision to meet client needs. This requirement was not met as evidenced by:
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The Administrator or Licensee agrees to send an attestation that this regulation has been read, understood and will be complied with and will send a plan detailing the changes the facility has made or will make to prevent a reoccurrence.
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Based on the former Administrator's own admission that there were occassions wherein there was no staff at the facility on a weekend which prevented the residents from coming back until the following day. This poses an immediate risk to the health, safety and personal rights of 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: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
08/14/2023 and conducted by Evaluator Maja Jensen
COMPLAINT CONTROL NUMBER: 27-AS-20230814164513

FACILITY NAME:WILTON STABLESFACILITY NUMBER:
342700065
ADMINISTRATOR:TANYA BARRETOFACILITY TYPE:
735
ADDRESS:11119 MANN ROADTELEPHONE:
(916) 687-4548
CITY:WILTONSTATE: CAZIP CODE:
95693
CAPACITY:4CENSUS: 4DATE:
12/01/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Kolu SokodoloTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff do not allow residents to leave the facility
Facility staff do not allow residents privacy
Facility staff are misusing client funds
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/1/23 Licensing Program Analyst (LPA) Maja Jensen arrived at facility announced to continue a complaint investigation in to the above listed allegations. LPA Jensen met with Administrator Kolu Sokdolo and explained the purpose of today's visit.

During the course of this investigation LPA's Maja Jensen and Christina Valerio interviewed the facility Regional Manager, the former Administrator, 4 current staff members, 1 former staff member, a service coordinator and a current resident. LPA Jensen also reviewed a report given by a resident family member, a copy of the program rules and regulations, LIC 405's for Resident 1 (R1) and receipts for R1.

Facility staff do not allow residents to leave facility
All parties interviewed denied that residents were unable to leave the facility. Based on the interviews conducted the allegation of facility staff do not allow residents to leave the facility is UNSUBSTANTIATED. A finding of unsubstantiated means that while the allegation may have occurred, there is insufficent
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 27-AS-20230814164513
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: WILTON STABLES
FACILITY NUMBER: 342700065
VISIT DATE: 12/01/2023
NARRATIVE
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evidence to prove it.

Facility staff do not allow residents privacy
All parties interviewed denied that residents were not allowed privacy. Based on the interviews conducted the allegation of facility staff do not allow residents privacy is UNSUBSTANTIATED. A finding of unsubstantiated means that while the allegation may have occurred, there is insufficient evidence to prove it.

Facility staff are misusing client funds
LPA Jensen reviewed receipts and LIC 405's for R1. LPA Jensen was unable to reconcile the receipts with the accounting from 2017 to July of 2023 for R1. The Regional Manager that oversees the facility was unable to explain why LIC 405's did not match the receipts. It should be noted that as of 8/24/23 the LIC's accurately reflected the receipts available and the cash on hand. While it was evident that P&I funds were not accurately accounted for LPA Jensen was unable to find evidence of a misuse of funds. P&I fund inaccuracies will be addressed in a separate case management.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC9099 (FAS) - (06/04)
Page: 8 of 8