<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385601084
Report Date: 06/04/2021
Date Signed: 06/08/2021 05:38:16 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, 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
06/02/2021 and conducted by Evaluator Mohamed Filouane
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20210602153607
FACILITY NAME:LYNNE & ROY M FRANK RESIDENCESFACILITY NUMBER:
385601084
ADMINISTRATOR:POWONDRA, MATTHEW RFACILITY TYPE:
740
ADDRESS:ONE AVALON AVENUETELEPHONE:
(415) 469-2359
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:220CENSUS: 71DATE:
06/04/2021
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Edwina Tang and Robert SarisonTIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident is denied visitors.
Resident is denied phone calls.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 06/04/21, Licensing Program Analyst (LPA) Mohamed Filouane conducted a 10-day complaint inspection on-site visit with Executive Director (ED) Edwina Tang and Director of Campus Programs (DCP) Robert Sarison. LPA also closed this complaint in the same visit after obtaining requested documentation from the facility. LPA explained the purpose of the visit, reviewed the allegations, and then delivered the findings.

Concerning the above allegations of a resident being denied visitors as well as a resident being denied phone calls, LPA Filouane requested additional information from the Executive Director and Director of Campus Programs. In an interview with the ED and DCP, the DCP stated that the responsible party of the resident in question has requested the facility to prohibit any interaction and communication with the resident in question. The DCP states that on 05/26/21, a family member came to visit the resident in question in the lobby of the facility. It is reported by facility staff and the responsible party that a loud argument occurred after the resident in question interacted with the family member. It is reported that there is a history of verbal abuse and financial abuse towards the resident in question by this family member. The responsible party has also reported to Adult Protective Services. The responsible party states this family member's behavior is counterproductive and dangerous to the health of the resident in question.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Julio Montes
LICENSING EVALUATOR NAME: Mohamed Filouane
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021
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 14-AS-20210602153607
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LYNNE & ROY M FRANK RESIDENCES
FACILITY NUMBER: 385601084
VISIT DATE: 06/04/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA requested and obtained the letter from the responsible party requesting to deny visitation and communication with the family member, the LIC 601, as well as emails from facility staff to facility management reporting about the event on 05/26/21.

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.

This report was reviewed and discussed with the Executive Director. This report will be emailed to the Executive Director due to technical difficulties.
SUPERVISORS NAME: Julio Montes
LICENSING EVALUATOR NAME: Mohamed Filouane
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2