342700907-12-14-2023-27-AS-SRIN-CYXTRL-20231228135743

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700907
Report Date: 12/14/2023
Date Signed: 12/14/2023 03:19:02 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
10/12/2023 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20231012135025

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: 3	DATE:	12/14/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Monalyn Andrada		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff handled resident in a rough manner which resulted in injuries
Staff did not provide resident with privacy

INVESTIGATION FINDINGS:

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

The Department has determined the following as it related the aforementioned allegations. The investigation consisted of resident interviews, staff interview, records review, and outside agency interviews.

LPA interviewed residents. Based on an interview with R1, R1 stated that staff do their job and try to protect the residents. According to R1, staff have not handled R1 in a rough manner. LPA attempted to interview R2, but R2's interview could not confirm or deny the allegations.

Continues on LIC 9099 - C...
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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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Control Number 27-AS-20231012135025

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: 12/14/2023

NARRATIVE

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...Continued from LIC 9099

LPA interviewed 3 individuals from an outside agency. Based on their interviews, LPA learned that information provided was reported by residents and the alleged incidents were not observed by them. R1 is known to make false statements; however, all statements are looked into seriously. R1 was observed to have scratches and bruising on R1's back by outside agency staff. According to the outside agency observation, the marks were observed a few days after the incident. During the observation, the outside agency staff was unable to interview resident's alone due to facility staff being in the room and not leaving to give privacy. According to facility staff, they are not allowed to leave any of the resident's alone. According to resident's care plan, the staff are required to provide supervision at all times.

LPA reviewed Shared Information Reports. It was learned that R1 was engaging in behaviors, such as kicking cars, hitting staff, and falling on the ground. As staff attempted to help R1, R1 kicked the staff while dragging self, which cause the scrape on R1's back.

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. Per California Code of Regulations (CCRs) - Title 22, Division 6, no deficiencies cited.

An exit interview was held with Administrator Monalyn, and a copy of report was left at the facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC9099 (FAS) - (06/04)

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