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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700858
Report Date: 03/24/2023
Date Signed: 03/24/2023 09:48:43 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/20/2023 and conducted by Evaluator Renee Campbell
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20230320165826
FACILITY NAME:VIBRANT LIVING CARE HOMESFACILITY NUMBER:
392700858
ADMINISTRATOR:SADORRA, JAMESFACILITY TYPE:
735
ADDRESS:3115 ZACCARIA WAYTELEPHONE:
(209) 395-3280
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:4CENSUS: 4DATE:
03/24/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Doris Madrid, House ManagerTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Hazardous chemicals are accessible to residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 03/24/23, Licensing Program Analyst (LPA) Renee Campbell arrived unannounced to visit facility at approximately 9 am. LPA was met by House Manager Doris Madrid and explained the purpose of the visit.

LPA toured the facility with House Manager. The rooms toured included bedrooms, kitchen and bathrooms as well as the laundry room. Toxic chemicals were not seen to be accessible to residents. Cleaning agents were found to be locked up in storage closets througout the facility and were inaccessible to the residents.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.
Exit interview completed and a copy of report provided.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Emerita Curiel
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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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