342700936-6-4-2024-27-AS-CVAO-D5WVCA-20240604161846

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700936
Report Date: 04/28/2023
Date Signed: 06/04/2024 04:18:46 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/28/2023 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230228085654

FACILITY NAME:	OFODIRE CARE HOME II		FACILITY NUMBER:	342700936
ADMINISTRATOR:	OFODIRE, PEARL		FACILITY TYPE:	735
ADDRESS:	9400 FEICKERT DRIVE		TELEPHONE:	(916) 230-0690
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	4	CENSUS: 4	DATE:	04/28/2023
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Pearl Ofodire		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff are interfering with a client's visitations

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to deliver complaint investigation findings. LPA met with Administrator Pearl Ofodire and explained the purpose of the visit.

The department conducted interviews, reviewed facility records, reviewed legal records, and reviewed department records to determine the findings as it relates to the aformentioned allegations.

According to records review, Resident 1 (R1) is conserved by the Director of Department of Developmental Services. "Pursuant to Health and Safety Code section 416.19, Alta California Regional Center is responsible to carry out the duties and responsibilities of the conservatorship on behalf of the Director."
Continues on LIC 9099 - C...

On 06/04/2024, Administrator Pearl was notified that this report has been amended to change the finding from unfounded to unsubstantiated. Please see the attached LIC 9099 - C amendment for additional information.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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-20230228085654

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: OFODIRE CARE HOME II	FACILITY NUMBER: 342700936
	VISIT DATE: 04/28/2023

NARRATIVE

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Continued from LIC 9099
According to an interview with Alta Regional Center Representative, the allegation is not true. According to Valley Moutain Regional Center Representative, visitation with Resident 1 (R1) is allowed; however, there are guidelines that the facility/family must follow.According to R1's Individual Program Plan (IPP), a legal binding contract with the facility and regional center, visits with R1's mom must be scheduled and arranged with conservator (DDS), the regional center, and administrator. All other visitations, outings, or social activities are allowed without the need of scheduling. According to interviews with staff members, 3 out of 3 staff stated they have never denied residents to have visit or go out on outings. Staff stated their are residents that have family members come every month to visit, a resident who goes out on weekend visits, and residents who go to day program on most days of the week. Staff stated they follow the resident's IPP and behavior care plan.
According to department facility file review, there was a complaint with similar allegations (27-AS-20221109111908). Findings were concluded to be unfounded. Visitation Log Records were reviewed for January 2022 to April 2023. Records revealed multiple entries for each month showing that residents were visited by family member or outside agencies. Records show that individual who visited the facility were prompted to sign their signature along with the date and time of arrival and exit.

On 06/04/2024, LPA Valerio informed Administrator Pearl that this report was amended to change the finding from unfounded to unsubstantiated.

R1 moved into the home on 09/01/2022. The facility administrator and ACRC Service Coordinator set up a zoom meeting for R1 to see R1's mother (M1) on 09/10/2022. The facility assisted R1 to log on to the zoom meeting. According to Administrator Pearl, M1 did not log on to the zoom meeting. A visit was arranged for R1 to see R1's mother (M1) at her home on 11/19/2022. Staff took R1 to see M1; however, was denied access due to M1 stating the home was not ready for visitors. Due to the M1's exchange of threats via voicemail and text message to staff, Administrator Pearl informed ACRC to have visits be arranged in a neutral setting such as the Elk Grove Police Department or ACRC office. Since the occurrence on 11/19/2022, Administrator Pearl stated that ALTA and DDS agreed that there should be a neutral third person during scheduled visitation and that visitations should be in a neutral place.

Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Per California Code of Regulations (CCRs), 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: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC9099 (FAS) - (06/04)

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