342700850-5-30-2023-27-AS-KHOS-CSJJJQ-20230606070556

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700850
Report Date: 05/30/2023
Date Signed: 05/30/2023 02:18:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 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
03/09/2023 and conducted by Evaluator Kesha Lewis

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230309094020

FACILITY NAME:	TWIN CITIES BOARD & CARE HOME		FACILITY NUMBER:	342700850
ADMINISTRATOR:	LINDA MUSTIN		FACILITY TYPE:	735
ADDRESS:	11098 TWIN CITIES ROAD		TELEPHONE:	(209) 745-4380
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY:	15	CENSUS: 15	DATE:	05/30/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Bouillez, Kyle		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Facility staff yell at residents

INVESTIGATION FINDINGS:

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On 05/230/2023 LPA Kesha Lewis arrived unannounced to deliver findings for the alegation listed above. LPA met with, staff Kyle and explained the purpose of the visit.

Based upon review of records provided and in person interviews, the Department concludes that there is not enough evidence to support the alegation. based on interviews with staff and residents there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, and therefore the allegations are unsubstantiated.

Exit interview with and report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kesha Lewis
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

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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