397000817-12-12-2024-27-AS-LKIG-DCGPGZ-20241231101909

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 397000817
Report Date: 12/06/2024
Date Signed: 12/12/2024 03:57:16 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
09/11/2024 and conducted by Evaluator Kesha Lewis

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240911120128

FACILITY NAME:	GIER CARE HOME II		FACILITY NUMBER:	397000817
ADMINISTRATOR:	DOMINGA GIER		FACILITY TYPE:	735
ADDRESS:	2510 JIMINEZ WAY		TELEPHONE:	(209) 952-8545
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95209
CAPACITY:	6	CENSUS: 3	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Terersita Rilloque		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff hit resident with an object
Staff threatened resident
Staff not providing a safe environment for resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Kesha Lewis arrived at the facility unannounced to deliver findings for the above allegations. LPA was greeted by staff and explained the reason for the visit.

LPA Lewis gathered documentation interviewed staff and residents. Based on the interviews the above allegations are unsubstantiated. Interviews were conducted with residents at their day programs and with staff there was not any information gained during the interviews that would suggests there was an unsafe environment for residents in care or that residents are being abused.

A finding of unsubstantiated means that although the allegation may have happened, the preponderance of evidence does not prove it. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited.

An exit interview was held and a copy of this report was given.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kesha Lewis
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024

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 1