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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701264
Report Date: 08/22/2024
Date Signed: 08/22/2024 03:51:34 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
06/25/2024 and conducted by Evaluator Tung Truong
COMPLAINT CONTROL NUMBER: 27-AS-20240625133657
FACILITY NAME:NWABEKE CARE HOMEFACILITY NUMBER:
342701264
ADMINISTRATOR:NWABEKE, JAMES/THERESAFACILITY TYPE:
735
ADDRESS:8128 AUSTELL WAYTELEPHONE:
(279) 333-7930
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:4CENSUS: 4DATE:
08/22/2024
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Ebelechukwu IfyefobiTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Facility staff physically abused resident in care resulting in injuries
Facility staff verbally abused resident in care
Facility staff did not allow resident access to personal cell phone
Facility staff mismanaged resident's medication
INVESTIGATION FINDINGS:
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On 8/22/2024, Licensing Program Analyst (LPA) Tung Truong arrived unannounced to complete and delivery findings for a complaint investigation received on 6/25/2024. Upon LPAs arrival, Caregiver Ebelechukw Ifyefobi was present and contacted Administrator Theresa Nwabeke. LPA and Administrator Theresa Nwabeke discussed the conclusion for complaint and the findings. Administrator gave consent for Ebelechukwu to sign this report.

Throughout the course of the investigation, LPA conducted interviews and reviewed records. Based on record reviews, and staff and client interviews, there is insufficient evidence to support the allegations mentioned above. Based on client interviews, all clients stated that they were not being physically or verbally abused by staff. Clients stated staff did not take away any of their belongings. Clients stated they get their medications as prescribed. Client (R1) admitted to making false statements in regard to the allegations above. Based on staff interviews, staff denied the above allegations. Based on records review, client (R1) has a history of problematic behaviors including making false statement, aggression and property destruction.

As a result of the investigation, LPA finds the allegations above to be UNSUBSTANTIATED- A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview was conducted and a copy of the report was provided upon exit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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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