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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700203
Report Date: 10/04/2023
Date Signed: 10/04/2023 03:10:36 PM

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
07/31/2023 and conducted by Evaluator Angela Hood
COMPLAINT CONTROL NUMBER: 59-AS-20230731144604
FACILITY NAME:PEOPLE'S CARE KEYESPORT WAYFACILITY NUMBER:
342700203
ADMINISTRATOR:AMANDA BRITTFACILITY TYPE:
735
ADDRESS:8317 KEYESPORT WAYTELEPHONE:
(909) 342-7163
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:4CENSUS: 4DATE:
10/04/2023
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Amanda Britt, AdministratorTIME COMPLETED:
03:25 PM
ALLEGATION(S):
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-Staff speak inappropriately to client in care
-Client is not accorded dignity in his personal relationships with staff
-Staff blows smoke in clients face
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Hood arrived at the care home on 10/4/23 and met with the Administrator, Amanda Britt, and House Manager, Krystal Paulus, to deliver findings for a complaint investigation regarding the allegations listed above.

During the course of the investigation, LPA Sabrina Calzada conducted interviews. LPA Angela Hood conducted interviews as well.



***********************************************Continued on LIC9099-C**************************************************
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
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 2
Control Number 59-AS-20230731144604
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: PEOPLE'S CARE KEYESPORT WAY
FACILITY NUMBER: 342700203
VISIT DATE: 10/04/2023
NARRATIVE
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Interview with client (C1) indicated that staff (S2) blew smoke in their face, and they are upset with S2. C1 indicated that S2 told C1 that they were in their space and then blew smoke in C1's face. C1 indicated that they are upset with the Administrator for not getting back to them regarding their concerns. Interview with client (C2) indicated that they have never witnessed staff smoking in the care home. C2 indicated that the staff who do smoke go to the corner away from the care home. C2 indicated that all the staff are nice to the clients in care and none of the staff are rude.

Interviews with staff (S1, S2, & S3) indicated that the staff who smoke will go outside away from the facility during their breaks to smoke. Interviews with S2 and S3 indicated that there is no smoking in the care home. Interviews with S1 and S2 indicated that, when C1 is having behaviors, they will follow staff continuing the behavior. Interviews with S1 and S2 indicated that, on the day in question, C1 was having a behavior and followed S2 outside while they were on their break smoking. S2 indicated that there was a breeze outside and the smoke unintentionally blew toward C1. Interview with S1 indicated that S2 was already on their break when C1 went outside to talk to S2. Interviews with S1, S2, and S3 indicated that they have never witnessed staff speaking inappropriately to clients in care. S3 indicated that all staff treat clients with dignity.

Based on interviews conducted, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. No deficiencies are being cited during this visit.

Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2