365530011-9-9-2024-56-AS-EMAN-D99TMM-20240919145120

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 365530011
Report Date: 09/09/2024
Date Signed: 09/09/2024 10:26:05 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/07/2024 and conducted by Evaluator Melody Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20240607160451

FACILITY NAME:	BLU SKYYZ RESIDENTIAL CARE		FACILITY NUMBER:	365530011
ADMINISTRATOR:	KENNETH A LEONARD		FACILITY TYPE:	735
ADDRESS:	16251 NIGHT STAR CT		TELEPHONE:	(800) 680-1484
CITY:	FONTANA	STATE: CA	ZIP CODE:	92336
CAPACITY:	6	CENSUS: 1	DATE:	09/09/2024
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Princess Bowen		TIME COMPLETED:	10:35 AM

ALLEGATION(S):

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Staff verbally abusing clients in care.

INVESTIGATION FINDINGS:

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On 09/09/2024 at 10:05 AM, Licensing Program Analysts (LPAs) Melody Brown and Raquel Hernandez conducted an unannounced visit to the facility to deliver the findings of the above allegation. LPAs Brown and Hernandez were greeted and granted entrance by a staff member and LPAs Brown and Hernandez met with staff Princess Bowen. LPAs Brown and Hernandez identified themselves and discussed the purpose of the visit and the elements of the allegation with staff Princess Bowen.

The investigation was conducted by LPA Melody Brown. The investigation consisted of observation and interviews with relevant parties. The allegation indicates that staff verbally abusing clients in care.
During the investigation, LPA Brown did not find evidence to corroborate the allegation. Interviews with Client #1 (C1) indicated staffs at the facility are not verbally abusing C1. Interviews with three (3) of three (3) staffs indicated that they are not verbally abusing C1. During the facility visit on 06/10/2024 and 07/24/2024,
***Continuation in LIC9099C***

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

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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Control Number 56-AS-20240607160451

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507

FACILITY NAME: BLU SKYYZ RESIDENTIAL CARE	FACILITY NUMBER: 365530011
	VISIT DATE: 09/09/2024

NARRATIVE

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LPA Brown observed Staff #2 (S2) and Staff #3 (S3) not verbally abusing C1. LPA Brown observed S2 and S3 talking to C1 in a soft voice and with kindness. In addition, LPA Brown observed that S2 and S3 are providing appropriate care and supervision to C1 during the visit. Moreover, on 08/29/2024, LPA Brown contacted C1 Inland Regional Center (IRC) Caseworker and IRC Caseworker reported to LPA Brown that they are not aware that staff at the facility are verbally abusing C1. IRC Caseworker added that during their visit at the facility, they did not observe any sign that staffs at the facility are verbally abusing C1 and what they noted was staffs at the facility have good rapport with C1, that staffs at the facility have good relationships with C1.

Based on the evidence, the allegation that staff verbally abusing clients in care is UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.

An exit interview was conducted where this report, LIC9099 was discussed and provided to staff Princess Bowen.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Melody Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024

LIC9099 (FAS) - (06/04)

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