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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345002915
Report Date: 02/28/2024
Date Signed: 02/28/2024 09:20:03 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
12/13/2023 and conducted by Evaluator Cheyenne Ratajczak
COMPLAINT CONTROL NUMBER: 59-AS-20231213144339
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: 18DATE:
02/28/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Program Manager- Ashley Thomas TIME COMPLETED:
09:20 AM
ALLEGATION(S):
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Staff left clients unsupervised in a running vehicle.
INVESTIGATION FINDINGS:
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On 02/28/24, Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to deliver final findings Community Care Licensing (CCL) received on 12/13/23. 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.

Please continue to LIC 9099-C….
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
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-20231213144339
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: 02/28/2024
NARRATIVE
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Staff left clients unsupervised in a running vehicle.- Unsubstantiated

In an interview with Program Manager, Ashley Thomas, it was revealed that in the past drivers have honked their horn to indicate that they are at the client’s place of residence. Drivers are no longer honking because the facility has received complaints about the honking. The protocol is for staff is to walk up to the door to ring the bell.

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: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2