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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 390308140
Report Date: 08/08/2024
Date Signed: 08/08/2024 01:22:35 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 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
08/02/2024 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20240802161906
FACILITY NAME:CENTRAL VALLEY TRAINING CENTER, INC.FACILITY NUMBER:
390308140
ADMINISTRATOR:RAYMOND NYLENFACILITY TYPE:
775
ADDRESS:7603 MURRAY DRIVETELEPHONE:
(209) 951-1504
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:90CENSUS: 84DATE:
08/08/2024
UNANNOUNCEDTIME BEGAN:
10:46 AM
MET WITH:Michael CarrollTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff member physically abused participant in care
INVESTIGATION FINDINGS:
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On 8-8-24 at 10:46am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegation noted above. LPA met with program director (PD) Michael Carroll and explained the purpose of the visit. LPA conducted interviews with client1 (C1), staff1 (S1), S2, S3, and an additional witness (W1). Additionally, LPA reviewed incident report dated 6-28-24 and previous case management related to this incident on 7-10-24. LPA also reviewed training records for S2 and S3, and invidiualized program plan (IPP) for C1. Based on interview and record review, on 6-24-24, C1 was engaged in a behavior episode which involved C1 placing self on the ground and proceed in an extensive rolling motion which resulted in day program coordinating with C1's facility residence for early departure from the program that day. C1 returned to his residence on 6-24-24. It was revealed that various redness and bruising as well as torn clothing of C1 was observed immediately after the incident during a body check conducted by C1's facility staff with day program staff present. Day program continues to monitor C1 during program attendance and update care plan accordingly to address behaviors.

{Cont. on 9099C}

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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 27-AS-20240802161906
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CENTRAL VALLEY TRAINING CENTER, INC.
FACILITY NUMBER: 390308140
VISIT DATE: 08/08/2024
NARRATIVE
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Interviews conducted did not reveal any corroborated statements of staff performing any physical abuse occurring during the incident. As a result, the preponderance of evidence standard is not met and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Michael Carroll and a copy of this report was provided to Michael. Appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2