397005503-7-11-2024-27-AS-LKIG-D7GN59-20240724100911

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 397005503
Report Date: 07/11/2024
Date Signed: 07/11/2024 03:12:55 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
05/02/2024 and conducted by Evaluator Michael Bilger

COMPLAINT CONTROL NUMBER: 27-AS-20240502103003

FACILITY NAME:	MARYANN PATACSIL'S CARE HOME #2		FACILITY NUMBER:	397005503
ADMINISTRATOR:	MARILYN PATACSIL		FACILITY TYPE:	735
ADDRESS:	335 PRADO WAY		TELEPHONE:	(209) 477-4915
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	6	CENSUS: 4	DATE:	07/11/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Avelina Javiner		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff speak of clients in a demeaning manor
Staff locked client out of home

INVESTIGATION FINDINGS:

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On 7-11-24 at 1:30pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the complaint allegations noted above. LPA met with care staff member Avelina Javiner and explained the purpose of the visit. Administrator Marilyn Patascil was made aware of LPA's visit and purpose via phone and gave permission for care staff to sign in her absence. During this investigation, LPA conducted interviews with two staff members and five witnesses. LPA also reviewed facility file documentation including individualized program plan (IPP) for resident1 (R1), and admission agreement for R1. LPA also reviewed additional witness documentation pertaining to the allegations listed above.

Allegation: Staff speak of clients in a demeaning manor. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was determined that facility staff engaged in a conversation with witness1 (W1) on or about November 20th, 2023, regarding R1’s placement in a new licensed facility. Documentation reviewed alleged facility staff used foul language to describe R1 and another former client of the facility during this conversation. {Cont. on 809C}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

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-20240502103003

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: MARYANN PATACSIL'S CARE HOME #2	FACILITY NUMBER: 397005503
	VISIT DATE: 07/11/2024

NARRATIVE

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Interviews and record reviews conducted revealed no corroborated statements by witnesses or facility staff confirming these claims. As a result, there is not a preponderance of evidence to conclude staff spoke of clients in a demeaning manor, therefore 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.

Allegation: Staff locked client out of home. LPA conducted interviews and file reviews as noted above. Based on interviews and record reviews, it was determined that R1 discharged from facility on or about November 21st, 2023, with intention to move to another licensed facility. Interviews conducted revealed facility Administrator and additional staff were in process of collecting personal items for R1 while a transition team for the new facility was waiting. It was further revealed that after R1 exited the facility and was discharged from facility, the transition team for the new facility experienced challenges attempting to transfer R1 to their vehicle. Interviews conducted also revealed facility Administrator and additional staff were inside during this attempted transition and available. Additionally, this investigation revealed no corroborated statements confirming transition team knocking on facility’s front door to determine if entry way was locked and inaccessible for further assistance from facility staff. As a result, there is not a preponderance of evidence to conclude facility staff locked a client out of the home. Therefore, 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 care staff and a copy of this report was provided to care staf. Appeal rights provided. LIC 811 provided.

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

LIC9099 (FAS) - (06/04)

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