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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397005971
Report Date: 02/15/2022
Date Signed: 02/15/2022 11:58:57 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR., STE 260
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/26/2021 and conducted by Evaluator Tana Kinder
PUBLIC
COMPLAINT CONTROL NUMBER: 23-CR-20211026162730
FACILITY NAME:KAIR IN HOME SOCIAL SERVICES, INCFACILITY NUMBER:
397005971
ADMINISTRATOR:MONIQUE PERSONFACILITY TYPE:
430
ADDRESS:2105 W MARCH LANE, STE 2TELEPHONE:
(209) 954-0614
CITY:STOCKTONSTATE: ZIP CODE:
95207
CAPACITY:29CENSUS: DATE:
02/15/2022
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Foster Parent CoordinatorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Resource parent denied food to a child in the home as a form of
punishment.
INVESTIGATION FINDINGS:
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On 2/15/2022 at 1130am, Licensing Program Analyst (LPA), Tana Kinder spoke with the Resource Family Agency Foster Parent Coordinator to deliver complaint investigation findings. Prior to the meeting, LPA Kinder reviewed the agency’s file at the licensing office, including the complaint history, criminal background check, incident reports and facility personnel report summary. LPA Horne conducted a video inspection of the facility inside and out, using the video platform, Facetime and no citations were issued. LPA Kinder conducted 3 interviews and Licensing Program Manager Rodrigez conducted 1 confidential interview between 1/28/2022-2/02/2022. LPA obtained and reviewed the following documents: Resource certificate of approval, facility sketch of the resource home, needs and services plan. The allegation is: Resource parent denied food to a child in the home as a form of punishment. Based on 4 confidential interviews conducted, the resource parent did not directly deny food to the youth in care. Multiple interviews stated the resource parent denied the adopted youth in the resource home food as a form of discipline. The resource parent would communicate the consequence in front of the foster youth. Continued...
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rosa RodriguezTELEPHONE: (916) 662-1458
LICENSING EVALUATOR NAME: Tana KinderTELEPHONE: (916) 263-2000
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022
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 2
Control Number 23-CR-20211026162730
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR., STE 260
SACRAMENTO, CA 95833
FACILITY NAME: KAIR IN HOME SOCIAL SERVICES, INC
FACILITY NUMBER: 397005971
VISIT DATE: 02/15/2022
NARRATIVE
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Additionally, the resource parent would intentionally communicate other forms of discipline for various infractions done by the resource parent’s own kids in front of the foster youth as a form of control to discourage the youth from doing anything that would be displeasing to the resource parent. It was also communicated that the resource parent was disappointed with the foster youth for not going to the resource parent’s church. After church, the resource parent would stop at a restaurant and pick up food for everyone that would go to church and have the foster youth eat something from the home, because the resource parent would not bring a meal from the restaurant for the foster youth. Given the conflicting information and the way food and meals were addressed at the home, the above allegation is determined to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to provide the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted, and a copy of the report and appeal process was provided to the resource family agency.
SUPERVISOR'S NAME: Rosa RodriguezTELEPHONE: (916) 662-1458
LICENSING EVALUATOR NAME: Tana KinderTELEPHONE: (916) 263-2000
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2