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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700743
Report Date: 09/25/2025
Date Signed: 09/25/2025 11:57:26 AM

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
07/01/2025 and conducted by Evaluator Michael Bilger
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250701101713
FACILITY NAME:LA FAMILIA RESIDENCEFACILITY NUMBER:
392700743
ADMINISTRATOR:YEPIZ, GUADALUPE CRYSTALFACILITY TYPE:
735
ADDRESS:627 W TURNER ROADTELEPHONE:
(209) 310-2192
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:6CENSUS: 4DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Guadalupe Crystal YepizTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff do not have required training
Staff are not following physician orders
Staff are giving resident “edibles” that are not prescribed to resident
INVESTIGATION FINDINGS:
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On 9-25-2025 at 10:15am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegations noted above. LPA met with Administrator Guadalupe Crystal Yepiz and explained the purpose of the visit. During this investigation, LPA conducted interviews with two staff members and reviewed facility file documentation including staff training records, staff declaration statements, and medication log sheets. Additionally, LPA conducted a facility observation on 7-8-2025.
Allegation: Staff do not have required training. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews of a total of fourteen staff members, it was revealed that consistent and regulatory training has been conducted with staff members. Additionally, a review of additional documents to verify qualifications indicates staff members possess various levels of experience consistent with regulatory personnel requirements for staffing. Various checklists and certificates of completion indicate completed training. Interviews and declaration statements did not indicate any corroborated evidence of staff not receiving required training. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. {Cont. on 9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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 27-AS-20250701101713
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: LA FAMILIA RESIDENCE
FACILITY NUMBER: 392700743
VISIT DATE: 09/25/2025
NARRATIVE
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Allegation: Staff are not following physician orders. LPA conducted interviews and record reviews as noted above. Based on record review, it was revealed that medications for residents were consistently given as ordered between January 2025 to current. Additionally, a review of medication log sheets revealed matched physician orders. Interviews conducted did not reveal any corroborated statements to indicate physician orders not followed. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff are giving resident “edibles” that are not prescribed to resident. LPA conducted interviews, record reviews, and facility observation as noted above. Based interviews and observation, it was revealed that resident2 (R2) consumes edibles which are stored in a locked device located in the facility for safety purposes, however, no evidence exists through interviews, observation, or record review to indicate staff have dispensed edibles to R2. Additionally, edibles do not appear on medication log sheets reviewed or physician orders to indicate instruction for staff to dispense edibles. 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 Administrator and a copy of this report was provided. Appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
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