374604399-2-24-2023-08-AS-JRAE-CPH254-20230228160456

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604399
Report Date: 02/24/2023
Date Signed: 02/24/2023 01:21:11 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/07/2023 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20230207154558

FACILITY NAME:	SIERRA WAY HOME		FACILITY NUMBER:	374604399
ADMINISTRATOR:	GONZALEZ, GLORIA L		FACILITY TYPE:	735
ADDRESS:	189 MADRONA STRET		TELEPHONE:	(619) 328-7824
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	4	CENSUS: 4	DATE:	02/24/2023
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Gloria Gonzalez		TIME COMPLETED:	01:32 PM

ALLEGATION(S):

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Staff withheld food from clients.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver findings on the above allegation. LPA met with Administrator Gloria Gonzalez and we discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegation. The investigation consisted of LPA direct observation, interviews with facility staff and outside agency.

It was reported to CCL that staff withheld food from Client 1(C1) [an LIC 811 Confidential Names List was provided to the facility representative to identify the client.]. Interview with staff revealed on February 7, 2023 staff made lunch (sandwich) for themselves prior to taking C1 to a medical appointment. Client 2 (C2) was in the kitchen at that same time and asked staff for some of their sandwich. Staff stated they gave the extra sandwich they made to C2. C1 entered the kitchen as staff and C2 were finishing their food and C1 immediately asked for a sandwich.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

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 08-AS-20230207154558

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SIERRA WAY HOME	FACILITY NUMBER: 374604399
	VISIT DATE: 02/24/2023

NARRATIVE

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Staff advised C1 that there were no sandwiches available in the house, since it was their personal lunch and offered C1 fruit instead. C1 became extremely upset and stated that they were not going to their medical appointment. Staff further explained that C1 hoards food in their bedroom and attends church services throughout the week to receive free meals. Staff stated that C1 eats the free church meals in addition to all of the daily meals and snacks that C1 is provided at the facility.

LPA Interview with C1 revealed C1 receives three meals a day and snacks when requested. C1 went on to state that the food is good at the facility and has no problems at the facility. Interview with C3 revealed the food is good at the facility and they are always given enough food by the facility staff; including breakfast, lunch, dinner and snacks.

Interview with Administrator revealed on February 7, 2023 she received a call from C1 stating that staff did not want to give C1 a sandwich. Administrator stated that staff prepared and ate their personal lunch in the kitchen and shared a portion with C2 Administrator was told by staff that they did not share with C1 because they had already shared with C2 and there was no food left. Administrator was told by C1 that C1 ate an after program snack but wanted a sandwich also. Administrator advised C1 that there were no sandwiches in the facility at that time which caused C1 to become extremely upset. C1 stated that they were not going to their medical appointment. Staff later assisted C1 with filing a complaint with CCL since C1 did not understand the "complaint poster" in the facility.

Based upon the foregoing, the above listed allegation is unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegation is not valid.

An exit interview was conducted with Gloria Gonzalez and a copy of this report and Licensee/Appeal Rights (LIC9058, 3/22) were provided to Gloria Gonzalez whose signature below confirms receipt of documents.

SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Ramon Serrano
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

LIC9099 (FAS) - (06/04)

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