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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347006128
Report Date: 10/28/2024
Date Signed: 10/30/2024 03:11:20 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 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
09/09/2024 and conducted by Evaluator Zaria Turner
PUBLIC
COMPLAINT CONTROL NUMBER: 23-CR-20240909130801
FACILITY NAME:KALA HOUSE JR.FACILITY NUMBER:
347006128
ADMINISTRATOR:CHRIS CROSSFACILITY TYPE:
727
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:4CENSUS: 2DATE:
10/28/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Chris Cross, Facility AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff missed minor's scheduled appointments
Staff did not safeguard minor's personal belongings
Minor in care was not provided food
Staff did not ensure minor's health care needs were met
Staff are not following minor's behavioral care plan
Staff did not ensure proper supervision was provided to minors in care
INVESTIGATION FINDINGS:
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On October 28, 2024 at 9:00 AM Licensing Program Analyst (LPA) Zaria Turner and Licensing Program Manager (LPM) Rosa Rodriguez made an unannounced visit to deliver findings to the above facility and met with Chris Cross, Facility Administrator.

Prior to the meeting LPA Turner and LPA Shulz initiated the complaint investigation on September 10, 2024. No deficiencies were cited during that inspection. LPAs requested the following documents: staff and client rosters, staff schedule, medication logs, meal and grocery logs, incident reports, intake logs, and needs and services plans for each client. LPA Turner attempted 1 confidential interview and conducted 10 interviews between September 23, 2024 and September 30, 2024.

Based on evidence obtained and confidential interviews conducted during the investigation process the above allegations cannot be substantiated because there were inconsistent statements throughout the investigation process. Report continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rosa Rodriguez
LICENSING EVALUATOR NAME: Zaria Turner
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2024
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 23-CR-20240909130801
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CRP RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KALA HOUSE JR.
FACILITY NUMBER: 347006128
VISIT DATE: 10/28/2024
NARRATIVE
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 7 out of 11 interviews confirmed that staff attended medical appointments, provided meals, ensured health care needs were met, staff followed behavioral care plans, and supervised clients in care. In addition, LPA Turner was not able to qualify one client during the interview process, and was not able to obtain exact dates and times of incidents reported.

During the investigation LPA Turner was informed that C1 was removed from the facility without prior notification. Staff was not aware of C1 being discharge. Staff advised LPA Turner that C1 lost personal belongings in bedding and no other clients or staff took belongings. It was also confirmed that appointments were missed due to mis-communication between the parties involved. It was confirmed by staff members that C1 was the one listening to inappropriate music in the facility. Staff denied that there was a lack of supervision in the facility while client was in care. Lastly, LPA Turner was notified by staff that C1 was provided snacks when RP randomly picked them up from the facility. Staff were unable to provide fully cooked meals before they left the facility.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted, copy of this report and the Appeal Rights were discussed and provided to the licensee.
SUPERVISORS NAME: Rosa Rodriguez
LICENSING EVALUATOR NAME: Zaria Turner
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2024
LIC9099 (FAS) - (06/04)
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