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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385600111
Report Date: 08/24/2023
Date Signed: 08/24/2023 03:11:07 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SF COASTAL AC/SC, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/14/2023 and conducted by Evaluator Audrey Jeung
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20230814124550
FACILITY NAME:PROGRESS FOUNDATION - AVENUESFACILITY NUMBER:
385600111
ADMINISTRATOR:KIMBERLY TAYLORFACILITY TYPE:
772
ADDRESS:1443 - 7TH AVENUETELEPHONE:
(415) 242-8034
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:12CENSUS: 9DATE:
08/24/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Liliebeth Espiritu-Raj, Nicole Newell, Bernadette Navarro-SimeonTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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9
- Staff did not allow resident to possess their personal belonging
INVESTIGATION FINDINGS:
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13
LPA Jeung met with counselors and director of clinical administration in the absence of program director regarding a former resident who resided in facility from 7/20 to 8/3/23. LPA interviewed staff. Admission documents are not available for review.

LPA requested that former client's admission contracts be forwarded to LPA.

Based on interviews with staff, this allegation is determined to be unsubstantiated.
Although the allegation may have occurred or is valid, there is not enough evidence to prove the alleged violation did or did not occur.

Upon review of documents requested, this finding may be amended.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cara Smith
LICENSING EVALUATOR NAME: Audrey Jeung
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
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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