342700907-1-17-2025-27-AS-SDOB-DDKVWD-20250204154742

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700907
Report Date: 01/17/2025
Date Signed: 01/17/2025 01:12:07 PM

Unsubstantiated

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
10/14/2024 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20241014161220

FACILITY NAME:	HOPEFUL TOMORROW HOMES, LLC		FACILITY NUMBER:	342700907
ADMINISTRATOR:	ANDRADA, MONALYN		FACILITY TYPE:	737
ADDRESS:	12857 CHEROKEE LANE		TELEPHONE:	(916) 890-4282
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY:	4	CENSUS: 4	DATE:	01/17/2025
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Monalyn Andrada, Jojo Andrada		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility did not seek timely medical attention for resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a complaint investigation and deliver complaint investigation findings. LPA Valerio met with Administrator Monalyn Andrada, and explained the purpose of the visit. Administrator Monalyn designated Jojo to sign on her behalf.

Today, on 01/17/2024, LPA Valerio interviewed staff and reviewed resident records.

The following has been determined as it relates to the above aforementioned allegations. The investigation consisted of an interview with Resident 1 (R1), Interview with Staff 1 (S1) and Staff 2 (S2), interviews with outside witnesses (W1 and W2), review of facility records, and a review of medical records.

Continues on LIC 9099 - C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

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-20241014161220

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: HOPEFUL TOMORROW HOMES, LLC	FACILITY NUMBER: 342700907
	VISIT DATE: 01/17/2025

NARRATIVE

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Continued from LIC 9099
According to the RP, the facility did not provide medical attention to R1's health condition prior to R1 visiting a family member.

Based on review of facility records, daily program notes, which are written by staff, did not indicate that R1 showed signs of illness, discomfort, or any change of condition. Prior to R1's outside visitation to family, R1 was observed taking naps, eating breakfast, organizing items in rooms, watching TV, going on the treadmill twice, coloring, and shredding paper. Medication Administration Records (MAR) show that R1 was provided R1's daily medication that is prescribed from R1's medical condition.

According to an interview with Staff 1 (S1), R1 is able to communicate needs if R1 is not feeling well. S1 also works with R1 a lot and did not notice a change of condition. R1 was able to communicate to LPA the protocols of what staff would do in the event a change of condition was observed. According to an interview with Staff 2 (S2), S2 stated in May of 2024 all residents and staff were tested for COVID after R1 went to the hospital. All test came back negative. S2 stated that R1 was admitted to the hospital on 05/27/2024 after R1's family member took R1 to the ER. S2 recalled that staff did not mention any concerns of symptoms.

According to an interview with W1, W1 reported R1 being taken to the hospital after R1 was observed to have labored breathing. It was reported that the doctors informed W1 to take R1 to the emergency room.

Based on the review of hospital discharge paperwork, R1 was admitted to the hospital for low oxygen levels and treated for COVID. According to a review of Shared Information and Unusual Incident Reports submitted by the facility, the information detailed in the reports align with the information relayed by witnesses and staff.

According to an interview with R1, R1 was not able to recall or communicate events from May of 2024. However, R1 did inform LPA that R1 does tell staff when feeling sick and that staff give medication.

Based on all the information collected by the Department, although the allegation may have happened or is valid, here is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. California Code of Regulations (CCRs) - Title 22, no deficiencies cited. An exit interview was held and a copy of report was left at the facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025

LIC9099 (FAS) - (06/04)

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