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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345002915
Report Date: 02/22/2024
Date Signed: 02/22/2024 09:37:56 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
11/17/2023 and conducted by Evaluator Cheyenne Ratajczak
COMPLAINT CONTROL NUMBER: 59-AS-20231117161503
FACILITY NAME:RCCA COMMUNITY ACCESS PROGRAMFACILITY NUMBER:
345002915
ADMINISTRATOR:ELSTON, SHARRAEFACILITY TYPE:
775
ADDRESS:4980 WATT AVENUE SUITE CTELEPHONE:
(530) 933-1590
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:43CENSUS: DATE:
02/22/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:TIME COMPLETED:
09:37 AM
ALLEGATION(S):
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Staff did not meet client's toileting needs.
INVESTIGATION FINDINGS:
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On 02/22/24, Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to deliver final findings for the complaint Community Care Licensing (CCL) received on 11/17/23. LPA met with Program Manager (PM), Ashley Thomas, and explained the purpose of the visit.

During the course of this investigation, the Department conducted interviews and obtained pertinent documents relevant to the complaint investigation.

Please continue to LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 59-AS-20231117161503
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: RCCA COMMUNITY ACCESS PROGRAM
FACILITY NUMBER: 345002915
VISIT DATE: 02/22/2024
NARRATIVE
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Allegation: Staff did not meet client's toileting needs. Unsubstantiated

LPA obtained restroom logs. Logs provided for review were from 11/01/23 to 11/16/23. Based on the restroom logs it was determined that the facility is not accurately documenting when client’s toileting needs are met. Interviews indicated that the facility has a checking in process with clients in that staff mark off each client on a sheet of paper who attends program for each day. For clients who need toileting assistance, staff are to sign off when toileting needs are met. During the records review, it was found that clients would be marked present on the day of program, however staff would not notate if staff met client’s toileting needs on a particular date. Interviews further revealed that the program has had turnover with staffing therefore the department has been unable to determine if client’s toileting needs are actually met.

Based on this information, this allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are unsubstantiated.

Exit interview conducted and a copy of the report and appeal rights were left at the facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2