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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701106
Report Date: 09/25/2025
Date Signed: 09/25/2025 03:17:06 PM

Substantiated


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-20250701102202
FACILITY NAME:LA FAMILIA RESIDENCE 2 INC.FACILITY NUMBER:
392701106
ADMINISTRATOR:YEPIZ, GUADALUPE CRYSTALFACILITY TYPE:
735
ADDRESS:570 SANDPIPER CIRTELEPHONE:
(209) 331-9417
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:6CENSUS: 4DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Guadalupe Crystal YepizTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff do not have criminal record clearance.
Staff did not maintain privacy of resident’s personal information
INVESTIGATION FINDINGS:
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On 9-25-2025 at 1:03pm, 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 residents, and four staff members. Additionally, LPA reviewed facility file documentation including criminal record clearance statements, facility staff schedules, and other documentation pertaining to resident interactions with outside parties.
.
Allegation: Staff do not have criminal record clearance. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that staff5 (S5) and S6 were not associated with facility during their employment. It was further determined that S5 and S6 worked in excess of 5 days and are not currently employed by Licensee to work at this facility. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.
{Cont. on 9099C}
Substantiated
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)
Page: 1 of 5
Control Number 27-AS-20250701102202
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 2 INC.
FACILITY NUMBER: 392701106
VISIT DATE: 09/25/2025
NARRATIVE
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Allegation: Staff did not maintain privacy of resident’s personal information. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews it was determined that on 6-17-25, a monthly Psychiatry meeting was held at facility via zoom at approximately 3:30pm. During this meeting eight residents, along with Administrator and two other staff members met at facility in a group format. Physician joined this group via zoom call. Based on interview and other documentation, it was revealed that this meeting was intended to greet each resident individually while in the group setting to observe for side effects of medications and later discuss detailed medical information privately thereafter with staff and resident. Based on interview, it was also revealed that during the group zoom call, a resident revealed to the Physician that she experienced a seizure. Due to this occurrence, it was determined that the venue arranged by Licensee resulted in an atmosphere conducive to various medical and other personal information being revealed to unauthorized persons. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

Citations are issued under Title 22, Division 6. An additional immediate civil penalty of $500 is issued for each fingerprint clearance violation (Total $1000) in addition to citation issued. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights and LIC 811 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)
Page: 2 of 5
Control Number 27-AS-20250701102202
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 2 INC.
FACILITY NUMBER: 392701106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2025
Section Cited
CCR
80019(a)(2)(A)
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80019 Criminal Record Clearance. (a) The Department...shall have the authority to approve or deny…employment…, or presence in the facility, based upon the results of such review. (2) Section 1522(b) of the Health and Safety Code provides in part: In addition to the applicant, the provisions of this section shall be applicable to criminal convictions of the following persons: (A) Adults responsible for administration or direct supervision of staff. This requirement was not met as evidence by:
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Licensee will read regulation 80019 and submit a signed declaration of understanding to LPA by POC due date. Staff members are no longer employed at facility.
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Based on interview and record review, Licensee did not ensure criminal background clearances associated to facility for two staff members. This posed an immediate health and safety risk to residents in care.
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Type B
10/06/2025
Section Cited
CCR
80072(a(1)
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80072 Personal Rights. (a)…each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:

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Licensee will develop and submit a plan ensuring how residents health and other personal information is protected from being revealed to other unauthorized persons. Plan to be submitted to LPA by POC due date.

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Based on interview and record review, Licensee did not ensure an environment protecting the potential for private information of residents to be released to unauthorized persons. This posed a potential health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
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 appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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-20250701102202

FACILITY NAME:LA FAMILIA RESIDENCE 2 INC.FACILITY NUMBER:
392701106
ADMINISTRATOR:YEPIZ, GUADALUPE CRYSTALFACILITY TYPE:
735
ADDRESS:570 SANDPIPER CIRTELEPHONE:
(209) 331-9417
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:6CENSUS: 4DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Guadalupe Crystal YepizTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff do not have required training
Staff yelled at resident
Staff is working while intoxicated
Staff are not following physician orders
INVESTIGATION FINDINGS:
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On 9-25-2025 at 1:03pm, 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 residents, and four staff members. Additionally, LPA reviewed facility file documentation including facility staff schedules, medication log sheets, staff training records, and other declaration statements from individuals. Additionally, LPA conducted 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.
{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)
Page: 4 of 5
Control Number 27-AS-20250701102202
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 2 INC.
FACILITY NUMBER: 392701106
VISIT DATE: 09/25/2025
NARRATIVE
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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.

Allegation: Staff yelled at resident. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that staff have maintained appropriate interactions with residents with no corroborated evidence to conclude any staff member yelled at a resident. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff is working while intoxicated. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that no corroborated evidence existed to indicate staff members are or have worked while intoxicated. LPA’s observation did not reveal evidence of staff intoxication while working. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff are not following physician orders. LPA conducted interviews and record reviews as noted above. LPA conducted a review of medication log sheets for various residents. 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.

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)
Page: 5 of 5